The goal of this observational study is to evaluate, between patients with arterial hypertension and non hypertensive control group, * the prevalence of hidden hypercortisolism * the relationship between organ damage and oxidative stress level, cortisol secretion degree, sensitivity and peripheral activity
Study Type
OBSERVATIONAL
Enrollment
290
Determination of cortisol levels at 9.00 am after taking 1 mg of dexamethasone the previous evening at 11.00 pm (1mg DST)
Istituto Auxologico Italiano IRCCS
Milan, MI, Italy
RECRUITINGPrevalence of hidden hypercortisolism (HidHyCo)
The presence of HidHyCo will be evaluated through the determination of cortisol levels at 9.00 am after taking 1 mg of dexamethasone the previous evening at 11.00 pm (1mgDST). In case of 1mgDST \>1.8 µg/dL the patient will repeat the test and, if the result is confirmed, the patients is considered to have HidHyCo.
Time frame: At baseline
Evaluation of organ damage
Organ damage will be assessed by performing echocardiography, carotid echo-doppler (arterial stiffness) and microalbuminuria evaluation, which assess hypertensive heart disease, macro-angiopathy and hypertensive nephropathy, respectively
Time frame: At baseline
Evaluation of oxidative stress level
The determination of the degree of oxidative stress will be carried out in all patients by evaluating the enzymatic activity of dipeptidyl peptidase 3 (DPP3) in the serum
Time frame: At baseline
Evaluation of cortisol secretion degree
The cortisol secretion will be evaluated by measuring morning plasma ACTH and serum cortisol, 24-hour urinary free cortisol, serum cortisol at 09:00 after the administration of 1 mg dexamethasone at 11 PM on the previous day
Time frame: At baseline
Evaluation of glucocorticoid sensitivity
In all subjects, genotyping of the N363S, BclI, ER22/23EK polymorphisms of the GR gene and of the polymorphisms will be performed
Time frame: At baseline
Evaluation of glucocorticoid peripheral activity
Urinary free cortisol and urinary free cortisone will be measured in all subjects; their ratio will be used as measure of glucocorticoid peripheral activity
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Time frame: At baseline