Occasionally cortisol can cause mineralocorticoid-type hypertension.
Situations where encountered:
(1) ectopic corticotropin secretion
(2) pituitary dependent Cushing's syndrome
Clinical and laboratory findings:
(1) hypertension
(2) Cushing syndrome
(3) low plasma rennin and aldosterone levels
(4) elevated ratio of tetrahydrocortisol to tetrahydrocortisone in the urine
(5) correction of hypertension by correction of excessive cortisol production
Mechanism: Excessive cortisol may exceed the capacity of renal Type 2 11-beta-hydroxysteroid dehydrogenase (which normally inactivates it to cortisone). Sufficient cortisol is present to bind to mineralocorticoid receptors, resulting in hypertension.
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