Hypercortisolism Prevalence in Cardiovascular Practice

Welcome back to another HCP Live Peer Exchange series. In this episode titled, ‘Hypercortisolism Prevalence in Cardiovascular Practice,’ the expert faculty examine evolving perspectives on the prevalence, clinical presentation, and impact of hypercortisolism, particularly within cardiovascular populations. Historically, considered a rare condition characterized by classic Cushingoid features such as central obesity and moon face, the expert panel highlights how emerging evidence is challenging this traditional view. Recent data from the MOMENTUM study, presented at the American College of Cardiology, suggest that hypercortisolism may be far more common than previously recognized, with a prevalence of approximately 27% among patients with resistant hypertension.

The panelists emphasize that many patients with hypercortisolism do not exhibit the expected physical phenotype and may appear lean or otherwise clinically unremarkable, contributing to under recognition in practice. From a cardiology perspective, the expert faculty note that this has significant implications, as many patients seen in routine practice—particularly those with hypertension and type 2 diabetes—may have underlying cortisol dysregulation.

Throughout the discussion, the panel also reflects on how longstanding assumptions in both cardiology and endocrinology have contributed to underdiagnosis. Drawing parallels to primary aldosteronism, the expert faculty underscore the need to revisit clinical frameworks and increase awareness. Overall, the faculty highlight hypercortisolism as a more prevalent and clinically relevant condition than previously appreciated.

In the next episode, ‘Clinical Presentation of Hypercortisolism,’ panelists will continue their discussion on hypercortisolism and highlight the variable clinical presentation of hypercortisolism and challenge traditional assumptions based on classic Cushingoid features. The panel highlights the condition’s role as a continuum of metabolic dysfunction with significant cardiovascular and systemic consequences.