This episode, titled ‘Recognizing Hypercortisolism in Cardiology,’ features panelists discuss the clinical implications of emerging hypercortisolism data for cardiologists and how these findings should influence everyday practice. The panelists emphasize that, despite historically being considered rare, hypercortisolism is increasingly recognized as a common and underdiagnosed contributor to resistant hypertension and broader cardiometabolic disease.

The expert panel highlights that cardiologists frequently manage patients with complex medication regimens for hypertension, diabetes, and cardiovascular disease, yet often overlook potentially reversible underlying drivers such as cortisol excess. Faculty stress that identifying hypercortisolism offers an opportunity to address the root cause of disease, potentially reducing medication burden and improving outcomes across multiple conditions, including metabolic syndrome and glucose dysregulation.

Importantly, the panelists challenge existing clinical paradigms and screening algorithms, noting that hypercortisolism may be more prevalent than traditionally prioritized secondary causes of hypertension, such as renal artery stenosis or pheochromocytoma. As a result, the expert faculty advocate for incorporating routine screening in the cardiovascular practice, particularly with using the dexamethasone suppression test. Overall, the discussion underscores a shift toward more proactive, mechanism-driven care, encouraging cardiologists to rethink diagnostic strategies and prioritize detection of common, yet often overlooked, endocrine contributors to cardiovascular disease.

In the next episode, ‘Hypercortisolism and Guideline Implications,’ panelists will discuss how emerging data should inform updates to clinical guidelines for hypercortisolism screening. The panel highlights the need to prioritize detection of endocrine drivers in resistant hypertension.