Hypercortisolism Education

Hypercortisolism is a modifiable but often-missed driver of cardiovascular risk: chronically elevated cortisol raises blood pressure, worsens blood sugar control, and favors the visceral fat pattern tied to insulin resistance, and it does so in patients who look nothing like classic Cushing syndrome, which is exactly why large screening trials found it in roughly one in four people with resistant hypertension (MOMENTUM) or difficult-to-control type 2 diabetes (CATALYST), rates that climb higher still when both conditions overlap; because a routine morning cortisol misses this, the overnight dexamethasone suppression test is the screening step that actually catches it, and a positive result should prompt an endocrinology referral and cortisol-directed management delivered alongside, not instead of, ongoing blood pressure and glucose treatment, since the broader comorbidity burden seen in overt Cushing syndrome (hypertension in 50 to 90% of patients, cardiovascular disease in 20 to 30%) makes a strong case for treating cortisol as a cardiovascular risk factor worth actively screening for in preventive cardiology, not an endocrine curiosity to defer indefinitely.

This educational initiative is supported by an educational grant from Corcept Therapeutics. ASPC maintains full editorial oversight and approval of program content.