Should we evaluate for cardiovascular disease in patients with Cushing's syndrome?

Abstract

Current evidence indicates a strong association between Cushing's syndrome, characterized by a cluster of systemic complications and increased cardiovascular risk. The biological link is cortisol overproduction, which influences various pathogenetic processes leading to cardiovascular damage, a main cause of increased mortality. Anthropometric and biochemical profile (including fasting glucose, lipids, potassium and coagulation parameters), clinical blood pressure measurement and electrocardiogram should be routinely carried out. Oral glucose tolerance test, 24-h ambulatory blood pressure monitoring, echocardiography and carotid ultrasound are recommended for further evaluation. Search for cardiac and vascular damage, according to specialist's advice, is mandatory in complicated hypertension or diabetes, as part of a comprehensive assessment. A combination of treatments directed against the aetiology of hypercortisolism and aimed at controlling cardiovascular risk factors, is required in this complex condition.