Cardiovascular and Metabolic Consequences of Inherited and Acquired Adrenal Disorders
Year: 2026
Type: book-chapter
Abstract: The adrenal gland is a vital endocrine organ whose hormones play an essential role in the physiological regulation of the cardiovascular and metabolic systems. Both inherited and acquired disorders of the adrenal gland can lead to hormone deficiency or excess, thereby directly causing various cardiovascular and metabolic diseases. By studying this chapter, you will clarify the normal physiological actions of the three major adrenal hormones – mineralocorticoids, glucocorticoids, and catecholamines – and understand the causal links between hormonal imbalance (whether excess or deficiency) and major clinical outcomes such as hypertension, diabetes mellitus, dyslipidemia, and cardiomyopathy. Ultimately, you will establish a clinical reasoning pathway from “adrenal hormone abnormality to cardiovascular-metabolic endpoints,” enabling a systematic approach to diagnosis and management. The adrenal gland is a vital endocrine organ, comprising the cortex and medulla, whose hormones play essential roles in cardiovascular and metabolic regulation. The cortex produces mineralocorticoids and glucocorticoids, while the medulla synthesizes catecholamines. These hormones regulate blood pressure, electrolyte balance, glucose and lipid metabolism, cardiac contractility, and vascular tone. Both inherited disorders—such as congenital adrenal hyperplasia, familial hyperaldosteronism, and pheochromocytoma susceptibility syndromes—and acquired conditions—including Cushing’s syndrome, primary aldosteronism, and adrenal insufficiency—can cause hormone excess or deficiency. Such imbalances directly contribute to hypertension, insulin resistance, diabetes mellitus, dyslipidemia, and cardiomyopathy. The pathophysiological mechanisms involve volume expansion, vasoconstriction, endothelial dysfunction, oxidative stress, inflammation, fibrosis, and a prothrombotic state. This chapter clarifies the normal physiological actions of the three major adrenal hormones and establishes causal links between hormonal imbalance and major cardiovascular-metabolic outcomes. Early recognition is critical: patients with resistant hypertension, hypokalemia, adrenal incidentaloma, or suggestive clinical features should undergo systematic screening using the aldosterone-to‑renin ratio, plasma or urinary metanephrines, and the 1-mg dexamethasone suppression test. Imaging modalities including adrenal CT, MRI, and adrenal vein sampling help localize the underlying pathology. Long-term multidisciplinary follow‑up, including stress‑dose glucocorticoid education for adrenal insufficiency, is essential. Ultimately, this chapter establishes a clinical reasoning pathway from “adrenal hormone abnormality to cardiovascular‑metabolic endpoints”, enabling a systematic approach to diagnosis and management that can reverse or mitigate many complications and improve patient outcomes.
Source: IntechOpen eBooks
Authors: Yingyu Bai, Xiongwen Chen
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7204136939