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Horm Metab Res 2007; 39(12): 908-914
DOI: 10.1055/s-2007-992813
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Circadian Blood Pressure Profile in Patients with Active Cushing's Disease and after Long-term Cure

F. Pecori Giraldi 1 , P. M. Toja 1 , M. De Martin 1 , A. Maronati 2 , M. Scacchi 1 , S. Omboni 2 , F. Cavagnini 1 , G. Parati 2
  • 1Chair of Endocrinology, University of Milan, Ospedale San Luca, Instituto Auxologico Italiano IRCCS, Milan, Italy
  • 2Department of Clinical Medicine and Prevention, University of Milano-Bicocca; Department of Cardiology, Ospedale San Luca, Instituto Auxologico Italiano IRCCS, Milan, Italy
Further Information

Publication History

received 12.02.2007

accepted 24.04.2007

Publication Date:
28 November 2007 (online)

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Abstract

Hypertension is a major feature of Cushing's disease, with the attendant increase in the rate of cardiovascular events. The circadian blood pressure profile also impacts cardiovascular risk and a few studies have shown that patients with Cushing's syndrome do not present the expected nocturnal blood pressure decrease and, further, that this alteration persists in short-range disease remission. These studies were performed by conventional discontinuous ambulatory pressure monitoring, a technique not devoid of limitations. Aim of our study was the assessment of blood pressure and heart rate profile by beat-to-beat noninvasive monitoring in twelve patients with active Cushing's disease (9 women and 3 men, age 33.3±2.36 years) and the assessment of its possible changes at short- (<1 year) and long-term (2-3 years) follow-up after curative surgery. No nocturnal blood pressure dipping (i.e., decrease by 10% of daytime values) was observed in 50% of patients both during active hypercortisolism and within 1 year from surgery. Recovery of blood pressure dipping profile was detected at long-term follow-up in a minority of patients. Daytime heart rate was higher in patients with active Cushing's disease and decreased over time after cure. In conclusion, patients with Cushing's disease present absent nocturnal blood pressure dipping and abnormal heart rate values which do not resolve after short-term remission of hypercortisolism and show only partial improvement in the long run. These findings identify additional cardiovascular risk factors for patients cured of Cushing's disease.

Key words

hypertension - cardiovascular risk - blood pressure dipping - hypercortisolism - treatment

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Correspondence

Prof. F. Cavagnini

Chair of Endocrinology

University of Milan

Ospedale San Luca

via Spagnoletto 3

20149 Milan

Italy

Phone: +39/02/61911 27 38

Fax: +39/02/61911 27 77

Email: cavagnini@auxologico.it