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TOPLINE:

Compared with a matched population-based control group, patients with Cushing syndrome continued to exhibit elevated systolic and diastolic blood pressures along with reduced kidney function at least 14 years after biochemical remission.

METHODOLOGY:

• Researchers in Germany conducted a retrospective cohort study to assess the long-term trajectory of blood pressure and kidney function in patients who achieved remission of Cushing syndrome.
• They included 81 patients with Cushing syndrome (median age at baseline, 44 years; 75.3% women) and compared them with 243 matched control individuals from a population-based cohort.
• Data were collected before treatment at baseline and at median follow-up intervals of 7.1 and 14 years after biochemical remission, with assessments of blood pressure, glomerular filtration rate, the prevalence of chronic kidney disease, and the use of antihypertensives.

TAKEAWAY:

• Patients with Cushing syndrome had a significant reduction in blood pressure and required fewer antihypertensives at both 7 and 14 years vs baseline.
• However, when compared with the control group, patients with Cushing syndrome had significantly elevated systolic and diastolic pressures at baseline and 7 and 14 years post-remission (P ≤ .0002 for all).
• Although the proportion of patients on antihypertensive medications decreased in the Cushing syndrome group after remission was achieved, the prevalence of uncontrolled hypertension remained higher than in the control group at all follow-up points. In fact, reducing the use of these medications was associated with an increased risk for uncontrolled hypertension.
• Kidney function assessed via glomerular filtration rate remained consistently lower among patients with Cushing syndrome than among control individuals at baseline and 7 and 14 years post-remission (P = .005, P < .0001, and P = .0359, respectively).

IN PRACTICE:

"Our findings provide further evidence that cardiovascular effects of hypercortisolism are not entirely reversible with the normalization of cortisol levels and enhance our understanding of the deteriorative long-term cardiovascular consequences of chronic hypercortisolism," the authors wrote.

SOURCE:

This study was led by Katrin Ritzel, Ludwig-Maximilians-Universität München (LMU Munich), LMU University Hospital in Munich, Germany. It was published online on July 29, 2025, in Journal of Endocrinological Investigation.

LIMITATIONS:

The retrospective design and single-centre nature of this study could have been considered limitations.

DISCLOSURES:

This study was supported by Else Kröner-Fresenius Stiftung. Some authors reported being supported by Deutsche Forschungsgemeinschaft, the Munich Clinician Scientist Program, the Clinician Scientist Pro­gramme on Rare Important Syndromes in Endocrinology, and other sources. All authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.