Impact of endocrine disorders on blood pressure.

Endocrine hormones contribute to the vascular tone in physiological conditions. A complex interplay between different endocrine axes orchestrates a wide range of mediators involved in blood pressure (BP) control. Endocrine disorders may then lead to a pathological rise in blood pressure, also known as secondary hypertension. Their identification may improve BP control or even properly resolve the disease, finally reducing the global cardiovascular risk burden. In addition, experimental evidence from endocrine disorders provided interesting insights about the pathophysiology of primary hypertension. In this regard, both diabetes and the calcium-/phosphate-regulating hormones are not only considered a main cause of endocrine hypertension but also key players in development of primary hypertension. The same pathophysiological mechanisms implicated in primary hypertension are also dysregulated in case of secondary hypertension due to endocrine disorders involving thyroid hormones, mineral- and glucocorticoids, growth hormone/insulin-like growth, and sexual hormones. Therefore, secondary hypertension may represent a paradigm for understanding pathophysiological mechanism underlying the control of BP and should be considered a source to identify potential biomarkers and even therapeutic target. Here, we summarize the current knowledge linking endocrine system and the development of hypertension. Direct effects of insulin, thyroid hormones, mineral- and glucocorticoids, growth hormone/insulin-like growth factor, sexual hormones, and calcium-/phosphorus- regulating hormones will be analyzed, also considering the complex interplay between those different pathways. Both clinical evidence and interventional clinical trials will be discussed also describing the potential clinical implications.