Adrenal adenomas, subclinical hypercortisolism, and cardiovascular outcomes

Purpose of reviewRecent evidence has highlighted the link between cardiovascular outcomes and incidentally discovered adrenal masses. The purpose of this review is to summarize the most recent findings on the cardiovascular profile of patients with nonfunctional adrenal adenomas.Recent findingsNonsecreting adrenal tumors, defined mostly by cortisol levels after dexamethasone suppression test below 1.8g/dl, are associated with impairment of markers of subclinical atherosclerosis such as intima-media thickness and flow-mediated vasodilation. The presence of impaired indices of insulin resistance could represent an additional factor that contributes to the worsening of the cardiovascular profile of those patients. No evidence of increased cardiovascular outcomes was found in this group of patients. On the contrary, according to the findings of recent long-term retrospective studies, patients with subclinical hypercortisolism have an increased incidence of cardiovascular outcomes and related mortality with respect to nonsecreting adrenal masses and to the general population.SummaryAn impaired cardiovascular profile is a common finding in patients with apparently nonfunctional adrenal masses. However, the incidence of cardiovascular outcomes and related mortality seems to be increased only in patients with mild cortisol hypersecretion.