The Design of MOMENTUM: A Prospective Study of the Prevalence of Endogenous Hypercortisolism in Individuals With Resistant Hypertension

Abstract

Hypertension affects up to 50% of US adults and resistant hypertension (rHTN) occurs in 10-20% of cases. Endogenous hypercortisolism (eHC) may contribute to rHTN in some individuals, but the prevalence of eHC in individuals with rHTN is currently unknown. The CATALYST study assessing eHC prevalence in individuals with difficult-to-control type 2 diabetes, reported a 40% prevalence of eHC in participants with systolic blood pressure (BP) ≥135 mm Hg despite taking ≥3 BP medications (Handelsman Y, et al. WCIRDC 2024. Poster 0050). MOMENTUM is the first large, prospective study to examine the prevalence of eHC in people with rHTN in the US.

MOMENTUM is an observational study of ∼1,000 adults with rHTN using American Heart Association criteria. Key exclusion criteria are investigator-determined white coat hypertension, nonadherence to BP medications, and individuals in whom the dexamethasone suppression test is difficult to interpret. The primary endpoint is to assess the eHC prevalence in this population. Key secondary endpoints are to assess clinical and laboratory features associated with increased eHC risk. Hyperaldosteronism will also be screened for. Descriptive statistics will be used to characterize participants with and without eHC.

In conclusion, the MOMENTUM study, as designed and currently enrolling, will provide an estimate of eHC prevalence and its associated clinical characteristics in people with rHTN. (ClinicalTrials.gov Identifier: NCT06829537)