Select Language:
High blood pressure remains one of the most widespread health issues globally. While many individuals can manage their blood pressure with medication, some continue to experience high readings regardless of treatment, a condition known as resistant hypertension. This affects millions, including nearly 10 million Americans. For years, healthcare providers have struggled to understand why certain patients do not respond to standard therapies. Recent research from the MOMENTUM study offers new insights.
The study revealed that over 25% of individuals with resistant hypertension have hypercortisolism, a condition characterized by excessive production of cortisol, the so-called “stress hormone.” This research, conducted across 50 U.S. medical centers and involving more than 1,000 participants, is the largest of its kind in the nation. Its findings strongly suggest that elevated cortisol levels might be a key contributor to stubborn high blood pressure.
Cortisol is produced by the adrenal glands and plays a crucial role in responding to stress. When functioning normally, it helps regulate blood sugar, supports metabolic processes, and manages inflammation. However, chronically high cortisol levels can lead to serious health issues such as weight gain, muscle weakness, and diabetes. Additionally, cortisol influences how the body handles salt and water, which can drive blood pressure higher—a possible explanation for why some individuals remain hypertensive despite multiple medications.
To test cortisol levels, researchers employed a straightforward method. Participants took dexamethasone, a medication administered overnight that typically reduces cortisol production. Blood samples taken the following morning showed that, in some individuals, cortisol remained elevated, indicating overproduction. Out of 1,086 participants, 297 exhibited hypercortisolism—that’s about 27%, a surprisingly high number that challenges previous assumptions. These findings highlight that excess cortisol might often be an overlooked cause of resistant hypertension.
The study also identified other hormone-related issues. About 20% of participants had primary hyperaldosteronism, a condition where the body produces too much aldosterone, a hormone that raises blood pressure by increasing salt retention. Some individuals had both conditions, which could make blood pressure harder to control. Furthermore, those with impaired kidney function appeared more prone to high cortisol levels, hinting at a potential risk factor and emphasizing the need for targeted testing in specific populations.
These insights underscore the importance of looking beyond standard treatments. Instead of merely increasing medication doses, healthcare providers might need to investigate underlying hormonal imbalances like hypercortisolism. Such testing could reveal hidden causes of treatment failure and guide more personalized and effective interventions.
While these findings are promising, it’s important to note that the study does not establish a direct cause-and-effect relationship between high cortisol and resistant hypertension. Further research is warranted to determine whether reducing cortisol levels can safely lower blood pressure.
Nonetheless, this discovery suggests that many patients could have underlying, undiagnosed conditions contributing to their high blood pressure. Identifying and addressing these issues could significantly improve health outcomes and reduce the risk of serious complications, including heart attacks and heart failure.
The MOMENTUM study marks a significant step forward in understanding resistant hypertension. It brings to light the potential prevalence of excess cortisol and underscores the importance of personalized treatment approaches. For individuals struggling to control their blood pressure, these findings offer new hope and avenues for future intervention.
Additionally, emerging research indicates that early time-restricted eating might help improve blood pressure, and natural coconut sugar could potentially reduce artery stiffness and blood pressure. Other studies have linked added sugar intake to higher blood pressure and shown that vitamin D supplementation may benefit those with diabetes.
Source: Mount Sinai Health System.
ChatGPT
Perplexity
Gemini AI
Grok AI
