Question: Does blood pressure always return to normal after Cushing's is resolved? If not, why would it still stay high if my Cushing's is gone?

Answer: Blood pressure does not always normalize when Cushing's syndrome is resolved. It is likely that long-standing hypertension, regardless of its cause, changes the blood vessels so that hypertension persists after the original cause is removed. Another possibility, especially in patients older than 40 years, is that they would have developed "essential" hypertension even without Cushing's syndrome and that there is no causal relationship between the two disorders. Even if the hypertension does not normalize, it is often easier to control when Cushing's syndrome is resolved, so fewer medications may be needed.

Editor's Note: Dr. Nieman is Senior Investigator, PREB, NICHD, Deputy Branch Chief, PREB, NICHD, and Associate Director, IETP, NICHD-NIDDK at the National Institute of Health in Bethesda, MD. Dr. Nieman has been involved in the treatment of Cushing's patients for many years, conducts research in the field and has published extensively in this area.