Should Cushing's Syndrome be Considered as a Disease with High Cardiovascular Risk in Relevant Guidelines?

Curr Vasc Pharmacol. 2020;18(1):12-24. doi: 10.2174/1570161116666181005122339.

Abstract

A considerable amount of data supports a 1.8-7.4-fold increased mortality associated with Cushing's syndrome (CS). This is attributed to a high occurrence of several cardiovascular disease (CVD) risk factors in CS [e.g. adiposity, arterial hypertension (AHT), dyslipidaemia and type 2 diabetes mellitus (T2DM)]. Therefore, practically all patients with CS have the metabolic syndrome (MetS), which represents a high CVD risk. Characteristically, despite a relatively young average age, numerous patients with CS display a 'high' or 'very high' CVD risk (i.e. risk of a major CVD event >20% in the following 10 years). Although T2DM is listed as a condition with a high CVD risk, CS is not, despite the fact that a considerable proportion of the CS population will develop T2DM or impaired glucose tolerance. CS is also regarded as a risk factor for aortic dissection in current guidelines. This review considers the evidence supporting listing CS among high CVD risk conditions.

Keywords: Cushing's syndrome; arterial hypertension; cardiovascular risk factors; diabetes mellitus; metabolic syndrome..

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / physiopathology
  • Cushing Syndrome / diagnosis
  • Cushing Syndrome / epidemiology*
  • Cushing Syndrome / mortality
  • Cushing Syndrome / physiopathology
  • Diabetes Mellitus, Type 2 / epidemiology
  • Humans
  • Hypertension / epidemiology
  • Metabolic Syndrome / epidemiology
  • Prognosis
  • Risk Assessment
  • Risk Factors