Cushing, cortisol, and cardiovascular disease

Cushing's syndrome of glucocorticoid excess is named after the eminent Bost on neurosurgeon Harvey W. Gushing (1869-1939). The recognition that glucoco rticoid excess produces hypertension led to examination of the role Of cort isol in essential hypertension, but it is only over the last decade that ev idence has emerged to support the concept. Despite the widespread assumptio n that cortisol raises blood pressure as a consequence of renal sodium rete ntion, there are few data consistent with the notion. Although it has a ple thora of actions on brain, heart and blood vessels, kidney, and body fluid compartments, precisely how cortisol elevates blood pressure is unclear. Ca ndidate mechanisms currently being examined include inhibition of the vasod ilator nitric oxide system and increases in vasoconstrictor erythropoietin concentration.