A 52-year-old man arrives at the office complaining of bruising and muscle weakness. The patient's medical history is unremarkable, but he has smoked a pack of cigarettes every day for 30 years. The blood pressure is 160/110 mm Hg, and the pulse rate is 80 beats per minute. 29 kg/m² is the BMI. Facial plethora, a slight centripetal distribution of body fat, diffuse skin pigmentation, and bilateral peripheral edema are all visible on physical examination. The fasting blood glucose level is 160 mg/dL, and the creatinine level is 1.2 mg/dL. A lung mass is discovered on a chest x-ray. Which of the following is the most likely cause of this patient's elevated blood pressure?

Question

Quizplus · Accepted Answer

Eductional Objective: High cortisol levels, as seen in Cushing syndrome patients, frequently cause hypertension due to increased angiotensinogen production, adrenergic hypersensitivity, and activation of renal mineralocorticoid receptors, which induces sodium reabsorption. The combined effect results in increased blood volume and systemic vascular resistance.

A 52-Year-Old Man Arrives at the Office Complaining of Bruising