What is the mechanism of hypertension in patients with cushing syndrome
Hypertension in patients with hypercortisolism is multifactorial:
• Excessive cortisol exposure increases systemic vascular resistance by:
• Enhancing the effects of catecholamines and angiotensin II
• Suppressing synthesis of endogenous vasodilatory agents, including nitric oxide and prostaglandins
• Cortisol also stimulates sodium reabsorption in the distal nephron, and to a lesser extent in the proximal nephron
• Synthesis of certain mineralocorticoids are increased in corticotropin (formerly adrenocorticotropic hormone [ACTH])-dependent Cushing syndrome
