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库欣综合征患者高血压的诊断与管理:欧洲高血压学会内分泌性高血压工作组的立场声明与共识

Diagnosis and management of hypertension in patients with Cushing's syndrome: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension.

作者信息

Fallo Francesco, Di Dalmazi Guido, Beuschlein Felix, Biermasz Nienke R, Castinetti Frederic, Elenkova Atanaska, Fassnacht Martin, Isidori Andrea M, Kastelan Darko, Korbonits Márta, Newell-Price John, Parati Gianfranco, Petersenn Stephan, Pivonello Rosario, Ragnarsson Oskar, Tabarin Antoine, Theodoropoulou Marily, Tsagarakis Stylianos, Valassi Elena, Witek Przemysław, Reincke Martin

机构信息

Clinica Medica 3, Department of Medicine, University of Padova, Padova.

Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna.

出版信息

J Hypertens. 2022 Nov 1;40(11):2085-2101. doi: 10.1097/HJH.0000000000003252. Epub 2022 Aug 8.

Abstract

Endogenous/exogenous Cushing's syndrome is characterized by a cluster of systemic manifestations of hypercortisolism, which cause increased cardiovascular risk. Its biological basis is glucocorticoid excess, acting on various pathogenic processes inducing cardiovascular damage. Hypertension is a common feature in Cushing's syndrome and may persist after normalizing hormone excess and discontinuing steroid therapy. In endogenous Cushing's syndrome, the earlier the diagnosis the sooner management can be employed to offset the deleterious effects of excess cortisol. Such management includes combined treatments directed against the underlying cause and tailored antihypertensive drugs aimed at controlling the consequences of glucocorticoid excess. Experts on endocrine hypertension and members of the Working Group on Endocrine Hypertension of the European Society of Hypertension (ESH) prepared this Consensus document, which summarizes the current knowledge in epidemiology, genetics, diagnosis, and treatment of hypertension in Cushing's syndrome.

摘要

内源性/外源性库欣综合征的特征是一系列皮质醇增多症的全身表现,这些表现会增加心血管疾病风险。其生物学基础是糖皮质激素过多,作用于各种致病过程,导致心血管损伤。高血压是库欣综合征的常见特征,在激素过多情况恢复正常且停用类固醇治疗后仍可能持续存在。在内源性库欣综合征中,诊断越早,就能越早采取措施抵消皮质醇过多带来的有害影响。此类措施包括针对潜在病因的联合治疗以及旨在控制糖皮质激素过多后果的定制抗高血压药物。内分泌高血压专家以及欧洲高血压学会(ESH)内分泌高血压工作组的成员编写了这份共识文件,总结了目前关于库欣综合征高血压的流行病学、遗传学、诊断和治疗方面的知识。

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