Ambulatory blood pressure monitoring-derived short-term blood pressure variability is increased in Cushing%26apos;s syndrome

作者：Rebellato Andrea; Grillo Andrea; Dassie Francesca; Sonino Nicoletta; Maffei Pietro; Martini Chiara; Paoletta Agostino; Fabris Bruno; Carretta Renzo; Fallo Francesco^*

来源：Endocrine, 2014, 47(2): 557-563.

DOI：10.1007/s12020-014-0164-7

• Blood pressure
• Hypertension
• Cushing%26apos
• s syndrome

Cushing%26apos;s syndrome is associated with high cardiovascular morbility and mortality. Blood pressure (BP) variability within a 24-h period is increasingly recognized as an independent predictor of cardiovascular risk. The aim of our study was to investigate the short-term BP variability indices in Cushing%26apos;s syndrome. Twenty-five patients with Cushing%26apos;s syndrome (mean age 49 +/- 13 years, 4 males; 21 Cushing%26apos;s disease and 4 adrenal adenoma patients) underwent 24-h ambulatory BP monitoring (ABPM) and evaluation of cardiovascular risk factors. Cushing patients were divided into 8 normotensive (NOR-CUSH) and 17 hypertensive (HYP-CUSH) patients and were compared with 20 normotensive (NOR-CTR) and 20 hypertensive (HYP-CTR) age-, sex-, and BMI-matched control subjects. Short-term BP variability was derived from ABPM and calculated as the following: (1) standard deviation (SD) of 24-h, daytime, and nighttime BP; (2) 24-h weighted SD of BP; and (3) average real variability (ARV), i.e., the average of the absolute differences between consecutive BP measurements over 24 h. In comparison with controls, patients with Cushing%26apos;s syndrome, either normotensive or hypertensive, had higher 24-h and daytime SD of BP, as well as higher 24-h weighted SD and ARV of BP (P = 0.03 to P %26lt; 0.0001). No difference in metabolic parameters was observed between NOR-CTR and NOR-CUSH or between HYP-CTR and HYP-CUSH subgroups. ABPM-derived short-term BP variability is increased in Cushing%26apos;s syndrome, independent of BP elevation. It may represent an additional cardiovascular risk factor in this disease. The role of excess cortisol in BP variability has to be further clarified.

• 出版日期2014-11