Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, Naples, Italy.
Neuroendocrinology. 2010;92 Suppl 1:50-4. doi: 10.1159/000318566. Epub 2010 Sep 10.
Cushing's syndrome (CS) causes metabolic abnormalities that determine an increased cardiovascular risk not only during the active phase of the disease but also for a long time after cure. Cardiovascular complications, such as premature atherosclerosis, coronary artery disease, heart failure, and stroke, in patients with CS cause a mortality rate higher than that observed in a normal population. The increased cardiovascular risk is mainly due to metabolic complications, such as metabolic syndrome, but also to vascular and cardiac alterations such as atherosclerosis and cardiac structural and functional changes. In the clinical management of patients with CS the focus should be on identifying the global cardiovascular risk and the aim should be to control not only hypertension but also other correlated risk factors, such as obesity, glucose intolerance, insulin resistance, dyslipidemia, endothelial dysfunction and the prothrombotic state. Considering that remission from hypercortisolism is often difficult to achieve and that the cardiovascular risk can persist even during disease remission, care and control of all cardiovascular risk factors should be one of the primary goals during the follow-up of these patients.
库欣综合征（CS）可导致代谢异常，这不仅使疾病活动期患者的心血管风险增加，而且在治愈后很长时间内也会增加。CS 患者的心血管并发症，如早发动脉粥样硬化、冠状动脉疾病、心力衰竭和中风，导致死亡率高于正常人群。心血管风险增加主要是由于代谢并发症，如代谢综合征，但也与血管和心脏改变有关，如动脉粥样硬化和心脏结构和功能改变。在 CS 患者的临床管理中，重点应放在确定整体心血管风险上，目标不仅应是控制高血压，还应控制其他相关危险因素，如肥胖、葡萄糖耐量异常、胰岛素抵抗、血脂异常、内皮功能障碍和血栓形成状态。由于皮质醇增多症的缓解往往难以实现，并且即使在疾病缓解期间，心血管风险也可能持续存在，因此，在这些患者的随访中，应将控制所有心血管危险因素作为主要目标之一。
