Hypertension and other morbidities with Cushing&amp;rsquo;s syndrome associated with corticosteroids: a review

Peppa, Μelpomeni; Boutati, Eleni; Krania, Maria; Raptis, Sotirios A.

doi:10.2147/ibpc.s9486

Cited by 38 publications

(25 citation statements)

References 127 publications

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“…2,3 Pharmaceutical treatments include corticosteroids and immunosuppressive agents that help control the disease, but impair immunity resulting in increased risk of infection. 4,5 Prior studies highlighted the importance of immunizations by demonstrating the benefits of influenza vaccination in MG patients. 6 Influenza-like illnesses and pneumonia lead to worsened MG exacerbations.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with acute exacerbations of myasthenia gravis

et al. 2019

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Introduction The etiology of acute exacerbations of myasthenia gravis (MG) is not well understood and further characterization can lead to improved preventative measures. This study aims to characterize factors contributing to MG exacerbations. Methods A total of 127 MG patient charts were reviewed retrospectively (2011‐2016) to obtain demographics, immunizations, pharmaceutical records, contributing factors of each MG exacerbation, emergency department (ED) visits, hospitalizations, and duration. Results There were 212 exacerbations requiring 106 ED visits and 141 hospitalizations (average admission 6.5 days). Highest contributors were infections (30%) and medications that may worsen MG (19%), with 24% unattributed. Infection related exacerbations were associated with 44.3% of ED visits and 39.7% of hospitalizations. Patients prescribed beta‐blockers were associated with more exacerbations (P < .01). Patients prescribed medications that may worsen MG had a higher exacerbation frequency shortly after administration. Discussion Infections and cautioned medications are frequently factors in acute MG exacerbations needing urgent medical attention and warrant caution.

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Section: Introductionmentioning

confidence: 99%

Factors associated with acute exacerbations of myasthenia gravis

et al. 2019

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“…It has been speculated that high prevalence of MetS among these patients might be the consequence of certain pharmacologic interventions, particularly of chronic corticosteroid therapy [43]. However, the presence of MetS in as much as 16% of 1494 young (35.2+13.4 years) SLE patients with rather short disease duration (24.1+18.0 weeks) seems to be enough to reject this relationship as causal [2].…”

Section: Metabolic Syndrome In Patients With Antiphospholipid Syndrommentioning

confidence: 99%

Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients

Jelic¹,

Nikolic²,

Marisavljević³

et al. 2017

A Critical Evaluation of Vitamin D - Clinical Overview

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In this chapter, the novel findings on interrelationship between vitamin D status and two well-known prothrombotic states, antiphospholipid syndrome, particularly its thrombotic phenotype, and metabolic syndrome will be reviewed. We shall present the results obtained from patients included in Serbian National Antiphospholipid Syndrome Registry, 68 patients with primary antiphospholipid syndrome (PAPS) and 69 patients with antiphospholipid syndrome associated with certain autoimmune rheumatic disease (sAPS), as well as 50 patients with pure metabolic syndrome (MetS). These results will be analysed and compared with the novel literature data. Prevalence of MetS in APS is high, with the atherogenic dyslipidaemia as its most prevalent characteristic. Prevalence of thrombotic events was significantly higher in APS patients with coexisting MetS, compared with those without MetS. Among APS patients, prevalence of VitD deficiency was significantly higher than in patients with pure MetS.VitD level was also significantly lower in APS patients with coexisting MetS or previous thrombotic events than in those without them. Elucidating interrelationships between VitD deficiency, MetS and thrombotic events in APS patients open up the possibility of distinguishing those subjects with the particularly high cardiovascular risk and ensuing need for the strict control of modifiable risk factors and VitD supplementation.

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“…GC were shown to support S324 Puzserova and Bernatova Vol. 65 vasoconstriction as they increase the response to NA, angiotensin II and other vasoconstrictors (Grunfeld et al 1985, Walker and Edwards 1994, Saruta 1996, Ullian 1999, Peppa et al 2011). Saruta (1996 found that the number of AT 1 receptors of vascular smooth muscle cells is significantly increased by GC.…”

Section: No and Hpa Axis Interaction In Stressmentioning

confidence: 99%

“…Thus GC may alter NO release from the endothelium, CNS and perivascular nervous system. In addition, corticosteroidinduced metabolic abnormalities, such as hyperglycemia, excess liberation of free fatty acids, increased plasma levels of triglycerides, insulin resistance and hyperinsulinemia exert pathological impact on endothelial function and appear to contribute to the corticosteroid-induced hypertension (Peppa et al 2011.…”

Section: No and Hpa Axis Interaction In Stressmentioning

confidence: 99%

Blood Pressure Regulation in Stress: Focus on Nitric Oxide-Dependent Mechanisms

Púzserová

Bernátová²

2016

Physiol Res

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Stress is considered a risk factor associated with the development of various civilization diseases including cardiovascular diseases, malignant tumors and mental disorders. Research investigating mechanisms involved in stress-induced hypertension have attracted much attention of physicians and researchers, however, there are still ambiguous results concerning a causal relationship between stress and long-term elevation of blood pressure (BP). Several studies have observed that mechanisms involved in the development of stress-induced hypertension include increased activity of sympathetic nervous system (SNS), glucocorticoid (GC) overload and altered endothelial function including decreased nitric oxide (NO) bioavailability. Nitric oxide is well known neurotransmitter, neuromodulator and vasodilator involved in regulation of neuroendocrine mechanisms and cardiovascular responses to stressors. Thus NO plays a crucial role in the regulation of the stress systems and thereby in the BP regulation in stress. Elevated NO synthesis, especially in the initial phase of stress, may be considered a stress-limiting mechanism, facilitating the recovery from stress to the resting levels via attenuation of both GC release and SNS activity as well as by increased NO-dependent vasorelaxation. On the other hand, reduced levels of NO were observed in the later phases of stress and in subjects with genetic predisposition to hypertension, irrespectively, in which reduced NO bioavailability may account for disruption of NO-mediated BP regulatory mechanisms and accentuated SNS and GC effects. This review summarizes current knowledge on the role of stress in development of hypertension with a special focus on the interactions among NO and other biological systems affecting blood pressure and vascular function.

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Hypertension and other morbidities with Cushing’s syndrome associated with corticosteroids: a review

Cited by 38 publications

References 127 publications

Factors associated with acute exacerbations of myasthenia gravis

Factors associated with acute exacerbations of myasthenia gravis

Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients

Blood Pressure Regulation in Stress: Focus on Nitric Oxide-Dependent Mechanisms

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