{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:01:59Z","timestamp":1789444919973,"version":"build-2803163510"},"reference-count":52,"publisher":"The Endocrine Society","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Corticosteroid excess is associated with adverse cardiovascular outcomes. Patients with Cushings's syndrome, either caused by endogenous or exogenous glucocorticoid excess, and patients with primary aldosteronism have increased cardiovascular risk. The increase in risk is mediated partly by traditional cardiovascular risk factors including hypertension and metabolic syndrome but also by other, less well-characterized mechanisms. Experimental and human studies have shown that target organ deterioration induced by aldosterone depends on concomitant high dietary salt intake. Key ongoing research questions that warrant further study by both clinical and experimental approaches include the following: 1) beyond inducing the metabolic syndrome, what are the mechanisms by which glucocorticoids are associated with excess cardiovascular risk, 2) what are the cellular pathways by which excessive mineralocorticoid receptor activation brings about cardiovascular and renal damage, and 3) why is salt critical in this process?<\/jats:p>","DOI":"10.1210\/en.2012-1573","type":"journal-article","created":{"date-parts":[[2012,10,19]],"date-time":"2012-10-19T18:11:26Z","timestamp":1350670286000},"page":"5137-5142","source":"Crossref","is-referenced-by-count":37,"title":["Adverse Cardiovascular Outcomes of Corticosteroid Excess"],"prefix":"10.1210","volume":"153","author":[{"given":"Eduardo","family":"Pimenta","sequence":"first","affiliation":[{"name":"Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Princess Alexandra and Greenslopes Hospitals, Brisbane, Queensland 4102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wolley","sequence":"first","affiliation":[{"name":"Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Princess Alexandra and Greenslopes Hospitals, Brisbane, Queensland 4102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stowasser","sequence":"first","affiliation":[{"name":"Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Princess Alexandra and Greenslopes Hospitals, Brisbane, Queensland 4102, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071612542696400_B1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/0002-9343(52)90027-2","article-title":"The natural history of Cushing's syndrome.","volume":"13","author":"Plotz","year":"1952","journal-title":"Am J Med"},{"key":"2020071612542696400_B2","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1056\/NEJM199409083311002","article-title":"Cushing's syndrome in children and adolescents. Presentation, diagnosis, and therapy.","volume":"331","author":"Magiakou","year":"1994","journal-title":"N Engl J Med"},{"key":"2020071612542696400_B3","first-page":"S37","article-title":"Dose-response relationships and mineralocorticoid activity in cortisol-induced hypertension in humans.","volume":"14","author":"Williamson","year":"1996","journal-title":"J Hypertens Suppl"},{"key":"2020071612542696400_B4","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/00004872-198708000-00007","article-title":"Effects of ACTH and cortisol administration on blood pressure, electrolyte metabolism, atrial natriuretic peptide and renal function in normal man.","volume":"5","author":"Connell","year":"1987","journal-title":"J Hypertens"},{"key":"2020071612542696400_B5","first-page":"795","article-title":"Blood pressure and metabolic effects of cortisol and deoxycorticosterone in man.","volume":"6","author":"Whitworth","year":"1984","journal-title":"Clin Exp Hypertens A"},{"key":"2020071612542696400_B6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1097\/00004872-198801000-00004","article-title":"Haemodynamic, hormonal and renal effects of adrenocorticotrophic hormone in sodium-restricted man.","volume":"6","author":"Connell","year":"1988","journal-title":"J Hypertens"},{"key":"2020071612542696400_B7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1291\/hypres.19.1","article-title":"Mechanism of glucocorticoid-induced hypertension.","volume":"19","author":"Saruta","year":"1996","journal-title":"Hypertens Res"},{"key":"2020071612542696400_B8","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/00004872-198907000-00005","article-title":"The hypertensive effect of synthetic glucocorticoids in man: role of sodium and volume.","volume":"7","author":"Whitworth","year":"1989","journal-title":"J Hypertens"},{"key":"2020071612542696400_B9","doi-asserted-by":"crossref","first-page":"R1444","DOI":"10.1152\/ajpregu.00294.2007","article-title":"Glucocorticoids increase salt appetite by promoting water and sodium excretion.","volume":"293","author":"Thunhorst","year":"2007","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"2020071612542696400_B10","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2147\/vhrm.2005.1.4.291","article-title":"Cardiovascular consequences of cortisol excess.","volume":"1","author":"Whitworth","year":"2005","journal-title":"Vasc Health Risk Manag"},{"key":"2020071612542696400_B11","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1161\/01.HYP.23.1.25","article-title":"Glucocorticoid increases angiotensin II type 1 receptor and its gene expression.","volume":"23","author":"Sato","year":"1994","journal-title":"Hypertension"},{"key":"2020071612542696400_B12","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/0140-6736(92)93225-C","article-title":"Primary aldosteronism: hypertension with a genetic basis.","volume":"340","author":"Gordon","year":"1992","journal-title":"Lancet"},{"key":"2020071612542696400_B13","doi-asserted-by":"crossref","first-page":"3623","DOI":"10.1210\/jc.2009-1399","article-title":"Update in primary aldosteronism.","volume":"94","author":"Stowasser","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071612542696400_B14","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1161\/01.HYP.0000079505.25750.11","article-title":"Primary aldosteronism and hypertensive disease.","volume":"42","author":"Mosso","year":"2003","journal-title":"Hypertension"},{"key":"2020071612542696400_B15","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1161\/HYPERTENSIONAHA.108.189141","article-title":"Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research.","volume":"51","author":"Calhoun","year":"2008","journal-title":"Hypertension"},{"key":"2020071612542696400_B16","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1001\/archinte.168.11.1159","article-title":"Characterization of resistant hypertension: association between resistant hypertension, aldosterone, and persistent intravascular volume expansion.","volume":"168","author":"Gaddam","year":"2008","journal-title":"Arch Intern Med"},{"key":"2020071612542696400_B17","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1136\/hrt.2003.020180","article-title":"Use of oral glucocorticoids and risk of cardiovascular and cerebrovascular disease in a population based case-control study.","volume":"90","author":"Souverein","year":"2004","journal-title":"Heart"},{"key":"2020071612542696400_B18","doi-asserted-by":"crossref","first-page":"764","DOI":"10.7326\/0003-4819-141-10-200411160-00007","article-title":"Taking glucocorticoids by prescription is associated with subsequent cardiovascular disease.","volume":"141","author":"Wei","year":"2004","journal-title":"Ann Intern Med"},{"key":"2020071612542696400_B19","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1002\/art.22418","article-title":"Glucocorticoids and cardiovascular events in rheumatoid arthritis: a population-based cohort study.","volume":"56","author":"Davis","year":"2007","journal-title":"Arthritis Rheum"},{"key":"2020071612542696400_B20","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jbspin.2010.02.040","article-title":"Cardiovascular risk induced by low-dose corticosteroids in rheumatoid arthritis: a systematic literature review.","volume":"78","author":"Ruyssen-Witrand","year":"2011","journal-title":"Joint Bone Spine"},{"key":"2020071612542696400_B21","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1210\/jc.2010-1942","article-title":"Mortality and morbidity in Cushing's disease over 50 years in Stoke-on-Trent, UK: audit and meta-analysis of literature.","volume":"96","author":"Clayton","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071612542696400_B22","doi-asserted-by":"crossref","first-page":"821","DOI":"10.7326\/0003-4819-130-10-199905180-00015","article-title":"Long-term mortality after transsphenoidal surgery for Cushing disease.","volume":"130","author":"Swearingen","year":"1999","journal-title":"Ann Intern Med"},{"key":"2020071612542696400_B23","doi-asserted-by":"crossref","first-page":"6348","DOI":"10.1210\/jc.2003-032180","article-title":"Transsphenoidal microsurgery for Cushing's disease: initial outcome and long-term results.","volume":"89","author":"Hammer","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071612542696400_B24","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1210\/jc.2006-2112","article-title":"Mortality in patients treated for Cushing's disease is increased, compared with patients treated for nonfunctioning pituitary macroadenoma.","volume":"92","author":"Dekkers","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071612542696400_B25","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jacc.2006.09.032","article-title":"Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies.","volume":"49","author":"Gami","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2020071612542696400_B26","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.amjmed.2006.02.031","article-title":"Metabolic syndrome and risk of cardiovascular disease: a meta-analysis.","volume":"119","author":"Galassi","year":"2006","journal-title":"Am J Med"},{"key":"2020071612542696400_B27","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/j.jacc.2010.05.034","article-title":"The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis.","volume":"56","author":"Mottillo","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2020071612542696400_B28","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1530\/EJE-07-0455","article-title":"Glucocorticoids and cardiovascular disease.","volume":"157","author":"Walker","year":"2007","journal-title":"Eur J Endocrinol"},{"key":"2020071612542696400_B29","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.jacc.2005.01.015","article-title":"Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism.","volume":"45","author":"Milliez","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"2020071612542696400_B30","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1001\/archinternmed.2007.33","article-title":"Cardiovascular outcomes in patients with primary aldosteronism after treatment.","volume":"168","author":"Catena","year":"2008","journal-title":"Arch Intern Med"},{"key":"2020071612542696400_B31","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1056\/NEJM199909023411001","article-title":"The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.","volume":"341","author":"Pitt","year":"1999","journal-title":"N Engl J Med"},{"key":"2020071612542696400_B32","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1056\/NEJMoa030207","article-title":"Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction.","volume":"348","author":"Pitt","year":"2003","journal-title":"N Engl J Med"},{"key":"2020071612542696400_B33","doi-asserted-by":"crossref","first-page":"5098","DOI":"10.1210\/en.2010-0465","article-title":"Minireview: aldosterone and mineralocorticoid receptors: past, present, and future.","volume":"151","author":"Funder","year":"2010","journal-title":"Endocrinology"},{"key":"2020071612542696400_B34","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1097\/MNH.0b013e3282f56854","article-title":"Mechanisms of mineralocorticoid receptor-mediated cardiac fibrosis and vascular inflammation.","volume":"17","author":"Young","year":"2008","journal-title":"Curr Opin Nephrol Hypertens"},{"key":"2020071612542696400_B35","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1161\/HYPERTENSIONAHA.107.095448","article-title":"Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism.","volume":"50","author":"Catena","year":"2007","journal-title":"Hypertension"},{"key":"2020071612542696400_B36","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1161\/01.CIR.95.6.1471","article-title":"Remodeling of the left ventricle in primary aldosteronism due to Conn's adenoma.","volume":"95","author":"Rossi","year":"1997","journal-title":"Circulation"},{"key":"2020071612542696400_B37","doi-asserted-by":"crossref","first-page":"5070","DOI":"10.1210\/jc.2005-0681","article-title":"Evidence for abnormal left ventricular structure and function in normotensive individuals with familial hyperaldosteronism type I.","volume":"90","author":"Stowasser","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071612542696400_B38","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1210\/jc.2002-021558","article-title":"Cardiovascular risk factors and common carotid artery caliber and stiffness in patients with Cushing's disease during active disease and 1 year after disease remission.","volume":"88","author":"Faggiano","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071612542696400_B39","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1038\/nature05488","article-title":"Abdominal obesity and metabolic syndrome.","volume":"444","author":"Despr\u00e9s","year":"2006","journal-title":"Nature"},{"key":"2020071612542696400_B40","first-page":"2664","article-title":"Persistence of increased cardiovascular risk in patients with Cushing's disease after five years of successful cure.","volume":"84","author":"Colao","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071612542696400_B41","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1210\/jc.2011-3123","article-title":"Body composition and cardiovascular risk markers after remission of Cushing's disease: a prospective study using whole-body MRI.","volume":"97","author":"Geer","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071612542696400_B42","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S0163-7258(02)00297-8","article-title":"Mechanisms involved in the side effects of glucocorticoids.","volume":"96","author":"Sch\u00e4cke","year":"2002","journal-title":"Pharmacol Ther"},{"key":"2020071612542696400_B43","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1001\/archinte.1994.00420010131015","article-title":"Glucocorticoids and the risk for initiation of hypoglycemic therapy.","volume":"154","author":"Gurwitz","year":"1994","journal-title":"Arch Intern Med"},{"key":"2020071612542696400_B44","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1161\/HYPERTENSIONAHA.108.123406","article-title":"Aldosterone and metabolic dysfunction: an unresolved issue.","volume":"53","author":"Pimenta","year":"2009","journal-title":"Hypertension"},{"key":"2020071612542696400_B45","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1161\/HYPERTENSIONAHA.108.122002","article-title":"Fasting plasma glucose and serum lipids in patients with primary aldosteronism: a controlled cross-sectional study.","volume":"53","author":"Matrozova","year":"2009","journal-title":"Hypertension"},{"key":"2020071612542696400_B46","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.2337\/dc07-0525","article-title":"Insulin resistance and hyperinsulinemia are related to plasma aldosterone levels in hypertensive patients.","volume":"30","author":"Colussi","year":"2007","journal-title":"Diabetes Care"},{"key":"2020071612542696400_B47","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1097\/HJH.0b013e3282861fa4","article-title":"A possible association between primary aldosteronism and a lower \u03b2-cell function.","volume":"25","author":"Mosso","year":"2007","journal-title":"J Hypertens"},{"key":"2020071612542696400_B48","first-page":"893","article-title":"Mineralocorticoid excess, dietary sodium, and myocardial fibrosis.","volume":"120","author":"Brilla","year":"1992","journal-title":"J Lab Clin Med"},{"key":"2020071612542696400_B49","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.mce.2011.09.008","article-title":"Mechanisms of mineralocorticoid salt-induced hypertension and cardiac fibrosis.","volume":"350","author":"Young","year":"2012","journal-title":"Mol Cell Endocrinol"},{"key":"2020071612542696400_B50","doi-asserted-by":"crossref","first-page":"2813","DOI":"10.1210\/jc.2011-0354","article-title":"Cardiac dimensions are largely determined by dietary salt in patients with primary aldosteronism: results of a case-control study.","volume":"96","author":"Pimenta","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071612542696400_B51","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1161\/HYPERTENSIONAHA.110.159277","article-title":"Dietary sodium, aldosterone, and left ventricular mass changes during long-term inhibition of the renin-angiotensin system.","volume":"56","author":"du Cailar","year":"2010","journal-title":"Hypertension"},{"key":"2020071612542696400_B52","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1161\/HYPERTENSIONAHA.107.100701","article-title":"Relation of dietary salt and aldosterone to urinary protein excretion in subjects with resistant hypertension.","volume":"51","author":"Pimenta","year":"2008","journal-title":"Hypertension"}],"container-title":["Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/endo\/article-pdf\/153\/11\/5137\/10384166\/endo5137.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/endo\/article-pdf\/153\/11\/5137\/10384166\/endo5137.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T22:19:21Z","timestamp":1594937961000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/endo\/article\/153\/11\/5137\/2424304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,11,1]]},"references-count":52,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2012,11,1]]}},"URL":"https:\/\/doi.org\/10.1210\/en.2012-1573","relation":{},"ISSN":["0013-7227","1945-7170"],"issn-type":[{"value":"0013-7227","type":"print"},{"value":"1945-7170","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11,1]]}}}