Endogenous Cushing's syndrome may be caused by overproduction of adrenocorticotropic hormone (ACTH) (Cushing's disease in most cases) or by an independent high cortisol secretion from the adrenal cortex.1 Cardiovascular impairments are frequent, due to hypertension, hyperglycemia, hypercholesterolemia, weight gain, and a prothrombotic state. The gene discussed is POMC; the disease is Cushing syndrome due to macronodular adrenal hyperplasia.