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Something that connects cortisol excess to aortic dilatation

Hypertension Research (2025)Cite this article

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I read with great interest the article by Yamazaki and colleagues reported that mild cortisol excess in patients with non-functional incidentaloma causes ascending aortic dilatation [1]. The graphical opinion in the paper is excellent, but it seems like an important one step is missing.

One of the most common causes of the ascending aortic dilatation is aging, as the authors wrote. With aging, elastin fracture in the aortic wall progresses and aortic stiffness increases. The progressive fracture of elastin fibers in the aortic wall is thought to be caused by the increase of strain and number of cycles [2]. Therefore, hypertensive effects, the authors pointed out, elevate the aortic strain, and result in the progression of the elastin fracture.

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References

  1. Yamazaki O, Chonan A, Yakuwa Y, Shibata S. Silent risk of ascending artery dilatation in non-functional adrenal incidentaloma. Hypertens Res. https://doi.org/10.1038/s41440-025-02274-0

  2. O’Rourke M, Adji A Aging, Growth and Maturation. In Nichols WW, O’Rourke F, Edelman ER, Vlachopoulos C (eds), McDONALD’S BLOOD FLOW IN ARTERIES. CRC Press: Boca Laton, 2022, 429-63.

  3. Aronson D. Cross-linking of glycated collagen in the pathogenesis of arterial and myocardial stiffening of aging and diabetes. J Hypertens. 2003;21:3–12.

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  4. London GM, Guerin AP. Influence of arterial pulse and reflected waves on blood pressure and cardiac function. Am Heart J. 1999;138:220–4.

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  5. Murakami T, Takei K, Ueno M, Takeda A, Yakuwa S, Nakazawa M. Aortic reservoir function after arterial switch operation in elementary school-aged children. Circ J. 2008;72:1291–5.

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  1. Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Japan

    Tomoaki Murakami

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  1. Tomoaki Murakami
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Correspondence to Tomoaki Murakami.

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Murakami, T. Something that connects cortisol excess to aortic dilatation. Hypertens Res (2025). https://doi.org/10.1038/s41440-025-02354-1

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