In Cushing's syndrome, which hemodynamic pattern is commonly observed?

• A. Persistent hypertension
• B. Hypotension only
• C. Episodic hypotension
• D. Hypertension with episodic hypotension

Answer: (C)

The main hemodynamic pattern in Cushing's syndrome is sustained hypertension. Excess cortisol boosts blood pressure mainly by promoting salt and water retention (mineralocorticoid‑like effects) which expands extracellular fluid, and by increasing vascular reactivity to catecholamines, raising total peripheral resistance. This combination tends to produce a persistent rise in blood pressure rather than episodic dips. Episodic hypotension is not typical of Cushing's; if blood pressure fluctuates with episodes, other conditions (such as pheochromocytoma, which causes paroxysmal hypertension) would be considered. So, persistent hypertension best fits the expected hemodynamic profile.