Adrenal "Incidentalomas" May Confer Cardiovascular Risk

By Joe Elia

Adrenal masses found in the course of abdominal imaging seem associated with an increased risk for cardiovascular disease, according to a Lancet Diabetes & Endocrinology article.

In a retrospective study, 198 patients with adrenal incidentalomas were followed over an average of 8 years. The patients were classified according to their cortisol levels after dexamethasone suppression: stable nonsecretors, intermediate (50 to 138 nmol/L) and subclinical Cushing's (above 138 nmol/L) secretors, and those whose cortisol levels increased over time. Roughly two thirds of the patients were nonsecretors.

The incidence of cardiovascular events was significantly higher in the intermediate or subclinical Cushing's group than in stable nonsecretors (17% vs. 7%); it was even higher (28%) among those whose cortisol levels increased. Cardiovascular mortality rates were also adversely affected, but cancer mortality was similar across the groups.

Commentators say the findings show the importance of follow-up and clinical monitoring of cardiovascular risk in these patients.