Investigating Endogenous Hypercortisolism Prevalence in a U.S. Population With Resistant Hypertension

BACKGROUND: Hypertension is a leading modifiable risk factor for cardiovascular disease and premature death among adults. Up to 18% of individuals with hypertension have resistant hypertension (rHTN), which substantially increases the risk of adverse clinical outcomes. Endogenous hypercortisolism can result in rHTN through multiple mechanisms. OBJECTIVES: MOMENTUM (NCT06829537) is the first large, observational, multicenter study examining the prevalence of endogenous hypercortisolism among adults with rHTN in the United States. METHODS: Target enrollment is approximately 1,000 participants. To be eligible, adults aged ≥18 years must have rHTN, defined using the American Heart Association criteria (systolic blood pressure ≥130 mm Hg despite ≥3 antihypertensive medications of different classes at maximally tolerated doses, including a diuretic, or ≥4 medications from different classes regardless of systolic blood pressure). Endogenous hypercortisolism is defined as cortisol level >1.8 μg/dL on the 1-mg overnight dexamethasone suppression test with adequate dexamethasone (≥140 ng/dL). The primary endpoint is endogenous hypercortisolism prevalence. CONCLUSIONS: MOMENTUM will provide new insight into endogenous hypercortisolism in patients with resistant hypertension.