The MOMENTUM Trial – The "Hidden Reason" Your Blood Pressure Won't Drop

Fresh from ACC.26, March 2026

High blood pressure is one of the most common challenges for people living with PAD — and new research just presented at the American College of Cardiology's 2026 Scientific Session may explain why some patients can't get theirs under control, no matter how many medications they try.

What the MOMENTUM Trial Found

MOMENTUM screened over 1,000 patients with "resistant" hypertension, defined as blood pressure that remains above target despite taking three or more medications, including a diuretic. The striking finding: 27% of those patients had an underlying hormonal condition called hypercortisolism, meaning their bodies were producing too much cortisol.

That's roughly 1 in 4 people whose blood pressure wasn't failing to respond to treatment because of their lifestyle or their medications, but because of an undiagnosed hormonal problem.

Why This Matters for PAD Patients

While MOMENTUM studied resistant hypertension broadly — not PAD specifically — the overlap is significant. High blood pressure is extremely common in PAD patients and can make the condition harder to manage. If a meaningful portion of those patients have an underlying cortisol issue driving their hypertension, that's worth knowing about.

The researchers are now calling for broader screening for hypercortisolism in patients with resistant hypertension, using a straightforward overnight hormone test.

What We Don't Know Yet

It's important to note that MOMENTUM measured how common hypercortisolism is in this group, it didn't test whether treating it actually lowers blood pressure. That research is still ahead. Randomized trials are the next step before this becomes standard clinical practice.

It's also worth knowing that the trial was funded by Corcept Therapeutics, a company that develops cortisol-modulating medications, and the lead researcher is a paid consultant to Corcept. The findings are significant, but that context is worth keeping in mind.

The Takeaway

If your blood pressure isn't responding to multiple medications, it may be worth asking your doctor whether an underlying hormonal issue could be a factor. This research is early, but it opens a genuinely new door toward understanding why some patients are so difficult to treat, and what to do about it.