The goal of this observational study is to evaluate, between patients with arterial hypertension and non hypertensive control group,

• the prevalence of hidden hypercortisolism
• the relationship between organ damage and oxidative stress level, cortisol secretion degree, sensitivity and peripheral activity

Inclusion Criteria:

• Hypertension group: arterial hypertension
• No hypertension group: absence of arterial hypertension

Exclusion Criteria:

• body mass index (BMI) >30 kg/m2
• active smoking (>20 cigarettes/day)
• pregnancy/lactation
• hypertension associated with family history of hypertension and cerebrovascular events before 40 years of age
• sleep apnea
• hypertension appearance in pre-pubertal age
• hypokalemia
• hypertension in the setting of an incidental adrenal mass
• classic signs and symptoms of hypercortisolism (lunar facies, striae, hypertrichosis, skin atrophy, hump)
• proven endocrine hypertension (pheochromocytoma, hyperaldosteronism, hyperparathyroidism, acromegaly, hyperthyroidism)
• renovascular hypertension
• diseases or conditions associated with increased activity of the hypothalamic-pituitary- adrenal axis and/or oxidative stress, such as type 2 diabetes, rheumatoid arthritis, severe rheumatic/autoimmune diseases, severe hematological diseases, alcoholism, depressive syndrome, chronic renal failure (GFR <45 ml/min), severe hypovitaminosis D (25OHvitaminD <10 ng/dL)
• therapies that interfere with the activity of the HPA axis (i.e. glucocorticoids, antidepressants).

Hypertension group: patients with hypertension referred to the cardiology clinics of Istituto Auxologico Italiano, Milan No hypertension group: patients without hypertension referred to endocrinology clinics of Istituto Auxologico Italiano for other diseases (e.g. euthyroid nodular goiter or chronic lymphocytic euthyroid thyroiditis)