Influence of adrenal subclinical hypercortisolism on hypertension in patients with adrenal incidentaloma.

[adrenal incidentaloma]

The purpose of our study was to clarify whether subtle cortisol-producing tumors , such as not only subclinical Cushing 's syndrome (SubCS ) but also subclinical hypercortisolism (SH ), influence the prevalence of hypertension , since numerous basic research studies have noted that glucocorticoid excess influences blood pressure .80 patients with adrenocortical adenomas (39 women and 41 men ; mean age 62 .1 years ) were enrolled . SubCS was diagnosed using a diagnostic criteria , and SH was diagnosed as the presence of a serum cortisol level greater than 50 nmol /L following 1 -mg dexamethasone suppression test (DST ).SubCS , SH , or non-functioning adrenocortical adenoma (NF ) was diagnosed in 14 , 13 , or 53 patients , respectively . The prevalence of hypertension differed significantly among the diagnoses (SubCS , 78 .6 %; SH , 84 .6 %; NF , 39 .6 %; P =0 .002 ), whereas no differences in other clinical characteristics such as age , sex , or waist girth were observed . The patients with SH had an 11 .7 -fold increased risk (95 % confidence interval : 1 .9 -72 .7 , P =0 .009 ) and those with SubCS had a 9 .5 -fold increased risk (95 % confidence interval : 1 .9 -48 .3 , P =0 .007 ) for hypertension compared to those with NF using a multivariate analysis .We demonstrated that subtle cortisol-producing tumors , such as SH as well as SubCS , were an independent risk factor for hypertension . The cut-off value of the 1 -mg DST would be appropriate to predict the development of hypertension .

Diseases
Validation

Diseases presenting "hypertension" symptom

achondroplasia

acute rheumatic fever

adrenal incidentaloma

aniridia

aromatase deficiency

cadasil

child syndrome

cohen syndrome

congenital adrenal hyperplasia

congenital diaphragmatic hernia

cushing syndrome

cystinuria

erdheim-chester disease

erythropoietic protoporphyria

esophageal adenocarcinoma

fabry disease

familial hypocalciuric hypercalcemia

gm1 gangliosidosis

heparin-induced thrombocytopenia

hereditary cerebral hemorrhage with amyloidosis

holt-oram syndrome

homocystinuria without methylmalonic aciduria

hydrocephalus with stenosis of the aqueduct of sylvius

inclusion body myositis

kallmann syndrome

kindler syndrome

lamellar ichthyosis

lymphangioleiomyomatosis

pendred syndrome

primary effusion lymphoma

scrub typhus

severe combined immunodeficiency

sneddon syndrome

typhoid

von hippel-lindau disease

well-differentiated liposarcoma

werner syndrome

x-linked adrenoleukodystrophy

zellweger syndrome

This symptom has already been validated