High blood pressure is one of the most common health problems in the world. Many people can control it with medication, but for some, blood pressure stays high even after taking several drugs.
This condition is known as resistant hypertension, and it affects millions of people, including nearly 10 million in the United States.
Doctors have long struggled to understand why some patients do not respond to treatment. Now, a major study called MOMENTUM has uncovered an important clue.
The research found that more than one in four patients with resistant hypertension have a condition called hypercortisolism. This means their bodies produce too much of a hormone called cortisol.
The study was conducted across 50 medical centers in the United States and included over 1,000 patients. It is the largest study of its kind in the country and provides strong evidence that excess cortisol may play a key role in difficult-to-control blood pressure.
Cortisol is often called the “stress hormone.” It is produced by the adrenal glands and helps the body respond to stress. In normal amounts, cortisol is essential for health. It helps control blood sugar, supports metabolism, and regulates inflammation. However, when cortisol levels remain high for a long time, it can cause serious problems.
High cortisol levels can lead to weight gain, muscle weakness, and diabetes. It can also raise blood pressure by affecting how the body handles salt and water. This may explain why some people continue to have high blood pressure even when they are taking several medications.
In the MOMENTUM study, researchers tested cortisol levels using a simple method. Participants took a medication called dexamethasone at night, which normally lowers cortisol levels. Blood samples were then taken the next morning. If cortisol levels remained high, it suggested the body was producing too much of the hormone.
Out of 1,086 participants, 297 were found to have hypercortisolism. This represents about 27 percent of the group, which is much higher than expected. This finding challenges what many doctors have been taught and suggests that excess cortisol may be a common hidden cause of resistant hypertension.
The study also found that some patients had other hormone-related conditions. For example, about 20 percent had primary hyperaldosteronism, a condition where the body produces too much aldosterone, another hormone that raises blood pressure. A smaller group had both conditions, which may make blood pressure even harder to control.
Another important observation was that people with reduced kidney function were more likely to have high cortisol levels. This suggests that certain patients may be at higher risk and could benefit from targeted testing.
The study highlights the importance of looking beyond standard treatments. Instead of simply adding more medications, doctors may need to investigate underlying causes. Testing for hormone imbalances like hypercortisolism could help explain why treatment is not working and lead to more effective solutions.
When reviewing these findings, it is clear that this research could change how resistant hypertension is managed. However, the study does not prove that high cortisol directly causes the condition. More research is needed to test whether treating hypercortisolism can lower blood pressure safely and effectively.
Even so, the results are very important. They suggest that many patients may have a hidden condition that has gone undiagnosed. Identifying and treating this condition could improve outcomes and reduce the risk of serious complications such as heart attacks and heart failure.
In conclusion, the MOMENTUM study provides new insight into the causes of resistant hypertension. It shows that excess cortisol may be much more common than previously thought and highlights the need for more personalized approaches to treatment.
For patients who struggle to control their blood pressure, this discovery offers new hope and a possible path forward.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more health information, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing vitamin D could improve blood pressure in people with diabetes.
Source: Mount Sinai Health System.
