Deepak Bhatt, MD, MPH, FACC, FAHA, FESC, MSCAI

In the final episode, ‘Hypercortisolism Recognition and Action in Resistant Hypertension,’ the panelists explored key takeaways from their discussion on the evolving role of hypercortisolism in resistant hypertension and cardiometabolic disease. Reflecting on the growing body of evidence linking cortisol excess to difficult-to-control hypertension, diabetes, and cardiovascular risk, the expert faculty emphasized the importance of rethinking traditional approaches to patient evaluation and management.

Hypercortisolism Recognition and Action in Resistant Hypertension

Throughout the discussion, the panel highlighted how emerging data have challenged long-held assumptions regarding secondary causes of hypertension. They acknowledged that many clinicians may not have routinely considered hypercortisolism when evaluating patients with resistant hypertension, obesity, difficult-to-control diabetes, or inadequate responses to standard therapies. As awareness increases, the panelists noted that opportunities exist to identify patients who may benefit from targeted evaluation and intervention.

The expert faculty discussed the potential clinical value of recognizing hypercortisolism earlier in the disease course. They emphasized that screening may uncover a treatable contributor to hypertension and cardiometabolic dysfunction, creating opportunities to improve outcomes and potentially reduce medication burden. The panel also reflected on the possibility that some patients may have underlying adrenal pathology or other forms of cortisol excess that can be addressed through specialized treatment approaches.

In their closing remarks, the panel of experts reinforced the importance of maintaining a high index of suspicion in patients with resistant hypertension. They encouraged clinicians to incorporate practical screening strategies into routine practice and highlighted the dexamethasone suppression test as a simple and accessible tool that may help identify patients requiring further endocrine evaluation. Ultimately, they emphasized that increased awareness, earlier recognition, and appropriate referral pathways may improve care for patients with hypercortisolism-associated hypertension. Thank you for watching this peer exchange series on hypercortisolism. Please subscribe to our newsletter for information on upcoming video series.

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In the final episode, ‘Hypercortisolism Recognition and Action in Resistant Hypertension,’ the panelists explored key takeaways from their discussion on the evolving role of hypercortisolism in resistant hypertension and cardiometabolic disease.

In this episode, ‘The Future of Hypercortisolism Care in Cardiology,’ the panelists explore how increasing awareness of hypercortisolism may reshape cardiovascular practice, education, and multidisciplinary care models. As emerging evidence continues to highlight the prevalence of hypercortisolism among patients with resistant hypertension and other cardiometabolic conditions, the expert faculty discuss how advances in screening and treatment could drive broader recognition of this underdiagnosed condition.

The Future of Hypercortisolism Care in Cardiology

The panel draws parallels between hypercortisolism and other diseases that were once considered rare, including cardiac amyloidosis, hypertrophic cardiomyopathy, and pulmonary hypertension. They examine how the availability of effective therapies transformed awareness, screening practices, and the development of specialized clinical programs in those fields, and consider whether a similar evolution may occur for hypercortisolism. The discussion highlights the potential role of cardiometabolic clinics and multidisciplinary collaborations involving cardiology, endocrinology, nephrology, and primary care in improving identification and management of patients with cortisol-related hypertension.

The faculty also reflect on the growing role of cardiologists in managing complex cardiometabolic diseases. Drawing comparisons to the widespread adoption of SGLT2 inhibitors and GLP-1 receptor agonists in cardiovascular care, they discuss how clinician comfort with new therapies can evolve as evidence accumulates and treatment options expand. In addition, the panel emphasizes the importance of education and training for future healthcare professionals, particularly regarding secondary causes of hypertension and the need for earlier evaluation of endocrine contributors to cardiovascular disease. The panel of experts discusses how improved screening, expanding therapeutic options, and collaborative care models may help optimize outcomes for patients with hypercortisolism and resistant hypertension.

The next episode in this series, ‘Hypercortisolism Recognition and Action in Resistant Hypertension,’ features the panelists discussing key clinical takeaways from emerging evidence linking hypercortisolism to resistant hypertension and cardiometabolic disease. They highlight the importance of screening, early recognition, and referral strategies that may help improve outcomes and reduce treatment burden for affected patients.

In this episode, ‘The Future of Hypercortisolism Care in Cardiology,’ the panelists explore how increasing awareness of hypercortisolism may reshape cardiovascular practice, education, and multidisciplinary care models.

This episode, titled ‘Emerging Therapies for Hypercortisolism,’ features panelists discussing the evolving treatment landscape for hypercortisolism and the growing body of research aimed at improving outcomes for patients with resistant hypertension, diabetes, and other cardiometabolic complications. Expert cardiology faculty explore how recent clinical studies have expanded awareness of hypercortisolism and highlight the importance of developing targeted therapies that address the underlying drivers of disease.

Emerging Therapies for Hypercortisolism

The panel examines current and investigational treatment approaches, including glucocorticoid receptor modulation and other emerging therapeutic strategies designed to more selectively target cortisol-related pathways. They discuss lessons learned from existing therapies and consider how newer agents may help overcome some of the limitations and adverse effects associated with earlier treatment options. Throughout the conversation, the expert faculty emphasize the need for continued clinical research to better define the role of these therapies in patients with varying degrees of cortisol excess.

The panelists also explore broader questions regarding disease characterization and treatment thresholds, including how future studies may help refine the definition of clinically meaningful cortisol elevation and identify patients most likely to benefit from intervention. They discuss the importance of randomized clinical trials and the role of surrogate markers such as blood pressure and glycemic control in demonstrating therapeutic benefit.

As the field continues to evolve, the panel highlights the potential for more selective therapies to expand treatment options and improve integration into cardiovascular practice. The discussion provides valuable insight into the future direction of hypercortisolism research and the opportunities that emerging therapies may create for patients with complex cardiometabolic disease.

The next episode in this series, ‘The Future of Hypercortisolism Care in Cardiology,’ features the panelists discussing how advances in hypercortisolism screening, treatment, and multidisciplinary care may transform the management of resistant hypertension and cardiometabolic disease. They explore the evolving role of cardiologists in identifying and coordinating care for patients with cortisol-related cardiovascular risk.

This episode, titled ‘Emerging Therapies for Hypercortisolism,’ features panelists discussing the evolving treatment landscape for hypercortisolism and the growing body of research aimed at improving outcomes for patients with resistant hypertension, diabetes, and other cardiometabolic complications.

In ‘Management and Treatment Goals in Hypercortisolism,’ our panel explores practical approaches to managing patients with hypercortisolism-associated hypertension following diagnosis and discusses the importance of addressing the underlying cause of disease. Expert cardiology faculty examine the role of cardiologists in identifying patients with hypercortisolism and emphasize the value of collaboration with endocrinology colleagues to confirm the diagnosis, determine the underlying etiology, and guide treatment decisions.

Management and Treatment Goals in Hypercortisolism

The panel discusses treatment goals for patients with hypercortisolism and resistant hypertension, highlighting the importance of moving beyond symptom management and focusing on the root cause of cortisol excess. They explore how identification of underlying hypercortisolism may open opportunities for targeted interventions, including surgical management in appropriate patients and medical therapies for those who are not candidates for surgery.

Throughout the discussion, the expert faculty consider how cardiologists can support ongoing blood pressure management while patients undergo evaluation and treatment for hypercortisolism. They review the rationale for selecting antihypertensive therapies that address pathways affected by cortisol excess and discuss how targeted treatment may help reduce medication burden and improve blood pressure control over time.

The panelists also reflect on the challenges associated with resistant hypertension and emphasize that persistent elevations in blood pressure may not always be explained by medication adherence alone. By recognizing hypercortisolism as a potential driver of treatment-resistant disease, clinicians may be better positioned to identify patients who require further evaluation and more individualized care. The discussion highlights the importance of diagnosis, referral, and targeted treatment as key steps toward improving long-term cardiovascular outcomes.

Our next episode, ‘Emerging Therapies for Hypercortisolism,’ explores the evolving treatment landscape for hypercortisolism and highlights ongoing research into more selective therapeutic approaches. The panelists discuss how emerging therapies and future clinical trials may help improve outcomes for patients with resistant hypertension, diabetes, and other cardiometabolic complications.

In ‘Management and Treatment Goals in Hypercortisolism,’ our panel explores practical approaches to managing patients with hypercortisolism-associated hypertension following diagnosis and discusses the importance of addressing the underlying cause of disease.

Deepak Bhatt, MD, MPH, FACC, FAHA, FESC, MSCAI

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