0055Prevalence of Endogenous Hypercortisolism in Individuals With Resistant Hypertension Stratified by Kidney Function: Results From the MOMENTUM Study

Background MOMENTUM (NCT06829537), the first US-based trial assessing endogenous hypercortisolism (HC) in individuals with resistant hypertension (rHTN), found an HC prevalence of 27.3%. Chronic kidney disease (CKD) is a cause and consequence of rHTN; however, the relationship between CKD and HC is not well characterized in rHTN. We performed an analysis of participants in MOMENTUM by renal function to evaluate this relationship. Methods MOMENTUM was an observational study that screened adults with rHTN (per American Heart Association criteria) using the 1-mg overnight dexamethasone suppression test (DST; HC=post-DST cortisol >1.8 μg/dL). Individuals with conditions that could confound DST interpretation were excluded. Historical estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 was exclusionary, but eGFR assessed at baseline was used for this analysis. The eGFR subgroups analyzed were <45, 45-59, and ≥60 mL/min/1.73 m2. Results Of the 1,086 MOMENTUM participants, 140 (12.9%), 203 (18.7%), and 743 (68.4%) had an eGFR <45, 45-59, ≥60 mL/min/1.73 m2, respectively, and the HC prevalence in these subgroups was 43.6%, 30.0%, and 23.6%, respectively. In participants with HC, mean eGFR was lower (P<0.0001) and mean urine albumin-to-creatinine ratio trended higher (P=0.097) compared to those without HC. Similarly, the frequency of HC was higher in the lower eGFR subgroups and higher CKD progression risk categories (P<0.0001 for any difference across groups). Conclusion MOMENTUM showed that individuals with rHTN and reduced kidney function have an elevated risk of HC, supporting the need for targeted screening in this high-risk population. Is this an encore abstract? No