# Investigating Endogenous Hypercortisolism Prevalence in a U.S. Population With Resistant Hypertension: MOMENTUM Rationale and Design

## TL;DR

This study aims to determine how common high cortisol levels are in U.S. adults with resistant hypertension.

## Contribution

MOMENTUM is the first large U.S. study to investigate endogenous hypercortisolism prevalence in resistant hypertension patients.

## Key findings

- MOMENTUM will enroll 1,000 participants with resistant hypertension.
- Endogenous hypercortisolism will be defined using specific cortisol thresholds.
- The study will provide new insights into the link between cortisol and resistant hypertension.

## Abstract

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.

MOMENTUM (NCT06829537) is the first large, observational, multicenter study examining the prevalence of endogenous hypercortisolism among adults with rHTN in the United States.

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.

MOMENTUM will provide new insight into endogenous hypercortisolism in patients with resistant hypertension.