Nearly 30 percent of patients with resistant hypertension have a hormone disorder caused by high cortisol, according to results from the MOMENTUM study presented at the American College of Cardiology Scientific Session on Mar. 31. The study was led by Deepak L. Bhatt, MD, MPH, MBA, Valentin Fuster Professor of Cardiovascular Medicine at the Icahn School of Medicine at Mount Sinai and Director of Mount Sinai Fuster Heart Hospital.
Resistant hypertension is a condition where blood pressure remains high despite treatment with three or more medications. This affects almost 10 million people in the United States. The new findings suggest that many patients may have underlying medical conditions such as hypercortisolism—when the body produces too much cortisol—that contribute to their resistance to conventional treatments.
Researchers analyzed data from 1,086 participants across 50 centers in the United States using a dexamethasone suppression test to measure cortisol levels. They found that 297 participants (27 percent) had hypercortisolism. The study also identified other factors associated with this condition, including poor kidney function and coexisting diseases like primary hyperaldosteronism—a disorder where too much aldosterone is produced—which was found in about 20 percent of participants; around six percent had both disorders.
Bhatt said, “The fact that such a high percentage (more than 25 percent) of patients with resistant hypertension have elevated cortisol levels is very different from what doctors have been historically taught in medical school. These findings should prompt more screening for excess levels of cortisol in patients with resistant hypertension.” He added, “The next step to further this research is conducting randomized trials to determine if therapies that lower the impact of cortisol can safely and effectively treat high blood pressure in these patients.”
The study’s sponsors included Corcept Therapeutics Incorporated; Dr. Bhatt serves as a paid consultant for Corcept Therapeutics Incorporated.
Mount Sinai Fuster Heart Hospital ranks No.2 nationally for cardiology and heart surgery according to U.S. News & World Report and No.1 in New York as well as No.6 globally per Newsweek’s rankings.
