American College of Cardiology Congress 2026 – Dr Deepak Bhatt (Mount Sinai Fuster Heart Hospital, New York, US) joins us to discuss primary results from the MOMENTUM study (NCT06829537; Corcept Therapeutics) investigating the prevalence and clinical impact of endogenous hypercortisolism in patients with resistant hypertension.

This prospective, cross-sectional observational study enrolled 1,143 patients across 50 sites in the United States. Eligible patients met AHA criteria for resistant hypertension, defined as blood pressure above target despite three or more maximally tolerated antihypertensive agents including a diuretic, or requiring four or more agents to achieve target. Endogenous hypercortisolism was identified within the patient cohort using an overnight 1mg dexamethasone suppression test. The confirmed cases underwent additional hormonal evaluation and non-contrast adrenal CT imaging. The study aimed to characterise the true prevalence of hypercortisolism in this patient population and identify clinical and laboratory features associated with the condition.

The study found a prevalence of hypercortisolism of 27.3% across the patients screened, with adrenal nodules observed in 24.3% of patients with hypercortisolism. Primary hyperaldosteronism screening was positive in 21.5% of these patients, with 5.9% screening positive for both hyperaldosteronism and hypercortisolism. 

Interview Questions:

1. Resistant hypertension remains a significant clinical challenge - what prompted the hypothesis that endogenous hypercortisolism may be an under-diagnosed driver in this condition?
2. Can you walk us through the MOMENTUM study design and how endogenous hypercortisolism is defined and identified?
3. What were the key findings of MOMENTUM?
4. How should these findings reshape the diagnostic workup for patients who fail to achieve blood pressure control on multiple antihypertensive agents - is routine cortisol screening now warranted?
5. What are your key take-home messages for cardiologists and hypertension specialists, and what are the next steps for research in this space?

Recorded on-site at ACC 2026, New Orleans.