{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:23:03Z","timestamp":1791332583008,"version":"4.3.1"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2004,12,3]],"date-time":"2004-12-03T00:00:00Z","timestamp":1102032000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2004,12]]},"abstract":"<jats:p><jats:bold><jats:sc>objective\u2002<\/jats:sc><\/jats:bold> In patients with Cushing's syndrome (CS) cardiovascular complications determine a mortality rate four times higher than in an age\u2010 and gender\u2010matched population. Therefore, we calculated the global cardiovascular risk in patients with CS.<\/jats:p><jats:p><jats:bold><jats:sc>design and patients\u2002<\/jats:sc><\/jats:bold> We applied the World Health Organization\u00a0\u2212\u00a0International Society of Hypertension (WHO\/ISH) 1999 guidelines for the estimation of cardiovascular risk in 38 females and 11 males with CS; 27 pituitary adenomas, 15 adrenal adenomas, four adrenal carcinomas and three ectopic ACTH\u2010secreting tumours. The risk of major cardiovascular events was estimated considering the combined effect of several risk factors (hypertension, diabetes, etc.), organ damage (left ventricular hypertrophy (LVH), proteinuria, etc.) and associated pathologies. Four categories of absolute cardiovascular disease risk were defined (low, medium, high, very high).<\/jats:p><jats:p><jats:bold><jats:sc>results\u2002<\/jats:sc><\/jats:bold> Eighty per cent of patients presented a \u2018high\u2019 or \u2018very high\u2019 cardiovascular risk; 85\u00b71% of the patients were hypertensive with a mild\u2010moderate hypertension (68%). Forty\u2010seven per cent of patients were diabetics and 41\u00b73% were obese. Hyperlipidaemia was less frequent (37\u00b75%). Fasting glycaemia was the only cardiovascular risk factor that correlated with a degree of hypercortisolism. Duration of disease correlated with the presence of obesity (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b70008) and hypertension (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b703) but not with the presence of diabetes or dyslipidaemia and seemed to be the only significant predictor of cardiovascular risk (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b703).<\/jats:p><jats:p><jats:bold><jats:sc>conclusions\u2002<\/jats:sc><\/jats:bold> Patients with active CS present a remarkably increased cardiovascular risk. Considering that the biochemical cure of hypercortisolism is often difficult to obtain, especially in Cushing's disease, and that cardiovascular risk could persist even after the \u2018cure\u2019, control of risk factors should be one of the primary goals of the therapy.<\/jats:p>","DOI":"10.1111\/j.1365-2265.2004.02168.x","type":"journal-article","created":{"date-parts":[[2004,12,3]],"date-time":"2004-12-03T09:34:20Z","timestamp":1102066460000},"page":"768-777","source":"Crossref","is-referenced-by-count":227,"title":["High cardiovascular risk in patients with Cushing's syndrome according to 1999 WHO\/ISH guidelines"],"prefix":"10.1111","volume":"61","author":[{"given":"Tatiana","family":"Mancini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blerina","family":"Kola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Mantero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Boscaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Arnaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,12,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1042\/cs0960513"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030871"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030514"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1563-2571.2000.200106.x"},{"key":"e_1_2_6_7_1","first-page":"2145\u20132162","volume-title":"Hypertension: Pathophysiology, Diagnosis and Management","author":"Biglieri E.G.","year":"1995"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.87.8.3662"},{"key":"e_1_2_6_9_1","first-page":"151","article-title":"WHO\u2010ISH Hypertension Guidelines Committee 1999. World Health Organization \u2013 International Society of Hypertension Guidelines for the Management of Hypertension","volume":"17","author":"Chalmers J.","year":"1999","journal-title":"Journal of Hypertension"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.84.8.2664"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(18)30099-9"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(86)90771-X"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.5.818"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1994.tb02486.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021558"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.33.6.1364"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.43.645"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.11.5301"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021518"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197210192871601"},{"key":"e_1_2_6_21_1","first-page":"1987","volume-title":"Hypertension: Pathophysiology, Diagnosis and Management","author":"Laragh J.H.","year":"1995"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.1.117"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)90878-9"},{"key":"e_1_2_6_24_1","unstructured":"Mancini T. Kola B. Concettoni C. Boscaro M. Mantero F.&Arnaldi G.(2003) Hypertension in patients with Cushing's syndrome: evidence for gender difference in 11\u03b2hydroxysteroid dehydrogenase type 2 activity. Abstract of the Endocrine Society 85th Annual Meeting ENDO 2003 Philadelphia June 19\u201322 2003; Abstract P2\u2010606 p.454."},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0960-0760(92)90077-V"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0960-0760(91)90165-2"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.9.1462"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00045415-200107000-00005"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00493-5"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1996.00853.x"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)92836-7"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.20.7.1183"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.1.245"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a117385"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2000.00603.x"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/0378-4347(95)00253-F"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.3.8277"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8545(02)00011-6"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2000.00609.x"},{"key":"e_1_2_6_40_1","unstructured":"Walker B.R. Souverein P.C. Wei L. Berard A. Egberts T.C.G. Leufkens H.G.M. Cooper C. Van Staa T.&MacDonald T.M.(2003) Glucocorticoid therapy increases event rates from cardiovascular disease; results from two pharmacoepidemiological studies of 265\u00a0445 participants.Abstract of the Endocrine Society 85th Annual Meeting ENDO 2003 Philadelphia June 19\u201322 2003; Abstract OR\u201030\u00b72 p. 101."}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-2265.2004.02168.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-2265.2004.02168.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T19:21:01Z","timestamp":1697224861000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2265.2004.02168.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,12]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2004,12]]}},"alternative-id":["10.1111\/j.1365-2265.2004.02168.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-2265.2004.02168.x","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,12]]}}}