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Purpose <p>Hypertension is the most frequent co-morbidity in active Cushing’s syndrome (CS) and regarded as a major cardio-vascular risk factor. It is unknown whether blood pressure and related parameters, such as kidney function, recover in the long-term following remission of CS.</p> METHODS <p>Blood pressure and related co-morbidities were analyzed in a cohort of 81 patients with CS (Cushing’s disease: 52, ectopic CS: 8, adrenal CS: 21) from a single tertiary care center. Patients were longitudinally evaluated at baseline, at 7.1 years (6.3–7.4) and at 14 years (13.5–14.4) after biochemical remission. Data were compared to a control group matched for BMI, age and sex (<i>n</i> = 243) from the “Cooperative Health Research in the Region of Augsburg” study (KORA) in a 1:3 fashion.</p> RESULTS <p>Patients with CS showed a higher median blood pressure and lower median glomerular filtration rate (GFR) compared to the matched controls, at baseline, 7 and 14 years after biochemical remission. Although the prevalence of hypertension and chronic kidney disease increased over time in the KORA cohort, patients treated for CS had a significantly higher prevalence of both comorbidities. Notably, the number of patients on antihypertensive medication declined in the Cushing’s cohort, resulting in significantly higher rates of uncontrolled hypertension at follow-up.</p> CONCLUSION <p>The prevalence of hypertension and impaired kidney function remained elevated in patients with CS years after biochemical remission, potentially contributing to an unfavorable long-term clinical outcome. This highlights the critical need for increased monitoring and treatment of co-morbidities in patients with CS following surgical remission.</p>

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Hypertension and kidney dysfunction despite long-term remission of Cushing’s syndrome

  • 期刊论文

  • 发表日期：

    2025年7月29日

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  • Katrin Ritzel,
  • Vanessa Fedtke,
  • Cornelia Then,
  • Elisabeth Nowak,
  • Frederick Vogel,
  • Leah Braun,
  • Stephanie Zopp,
  • Petra Zimmermann,
  • Annette Peters,
  • Margit Heier,
  • Birgit Linkohr,
  • Michael Roden,
  • Martin Bidlingmaier,
  • Felix Beuschlein,
  • Martin Reincke,
  • German Rubinstein

摘要

Purpose

Hypertension is the most frequent co-morbidity in active Cushing’s syndrome (CS) and regarded as a major cardio-vascular risk factor. It is unknown whether blood pressure and related parameters, such as kidney function, recover in the long-term following remission of CS.

METHODS

Blood pressure and related co-morbidities were analyzed in a cohort of 81 patients with CS (Cushing’s disease: 52, ectopic CS: 8, adrenal CS: 21) from a single tertiary care center. Patients were longitudinally evaluated at baseline, at 7.1 years (6.3–7.4) and at 14 years (13.5–14.4) after biochemical remission. Data were compared to a control group matched for BMI, age and sex (n = 243) from the “Cooperative Health Research in the Region of Augsburg” study (KORA) in a 1:3 fashion.

RESULTS

Patients with CS showed a higher median blood pressure and lower median glomerular filtration rate (GFR) compared to the matched controls, at baseline, 7 and 14 years after biochemical remission. Although the prevalence of hypertension and chronic kidney disease increased over time in the KORA cohort, patients treated for CS had a significantly higher prevalence of both comorbidities. Notably, the number of patients on antihypertensive medication declined in the Cushing’s cohort, resulting in significantly higher rates of uncontrolled hypertension at follow-up.

CONCLUSION

The prevalence of hypertension and impaired kidney function remained elevated in patients with CS years after biochemical remission, potentially contributing to an unfavorable long-term clinical outcome. This highlights the critical need for increased monitoring and treatment of co-morbidities in patients with CS following surgical remission.