Cushing Syndrome and Diastolic HTN

[BillrothI]

Hey Everybody,

Can anyone explain to me why diastolic hypertension occurs in Cushing syndrome?

My thought was that excess cortisol acts on mineralocorticoid receptors and increases fluid retention, thereby increasing pre-load, which can manifest as diastolic HTN. Is this accurate, or am I way off?

Thanks!

-Bill

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[W19]

High cortisol make the peripheral vessels very sensitive to catecholamines...

You are right that VERY high cortisol level cross-react with mineralocorticoid receptors, but does not increase aldosterone... still cause hypokalemia , however. Freaking weird!

 

[yankees527]

Cortisol increases expression of alpha 1 receptors

Alpha 1 receptors mediate peripheral vasoconstriction on arterioles (the main regulator of diastolic pressure), therefore you have increases sensitivity to SNS effects

That's my guess based on the normal physiology

 

[virajpatel]

Kinda going with @yankees527 but I would also like to add that there is an increased expression of Ang II receptors which will also increase sensitivity to AngII