A notable cortisol response to mental stress was associated with a higher risk of significant coronary artery calcification in healthy adults (OR 2.20; 95% CI 1.39-3.47).
Cross-Sectional (n=514)
Is heightened salivary cortisol response to mental stress associated with increased coronary artery calcification in healthy older adults?
Heightened salivary cortisol reactivity to mental stress is independently associated with a greater extent of subclinical coronary artery calcification in healthy older adults, supporting the role of hypothalamic-pituitary-adrenal activity as a CHD risk factor.
Odds Ratio: 2.2 (95% CI 1.39–3.47)
AIMS: Psychosocial stress is a risk factor for coronary heart disease (CHD), although the mechanisms are incompletely understood. We examined the cross-sectional association between the cortisol response to laboratory-induced mental stress and a marker of sub-clinical coronary atherosclerosis. METHODS AND RESULTS: Participants were 514 healthy men and women (mean age = 62.9 +/- 5.7 years), without history or objective signs of CHD, drawn from the Whitehall II epidemiological cohort. Salivary cortisol was measured in response to mental stressors, consisting of a 5 min Stroop task and a 5 min mirror tracing task. Coronary artery calcification (CAC) was measured using electron beam computed tomography. Approximately 40% of the sample responded to the stress tasks with a notable (>or=1 nmol/L) increase in cortisol. Significant CAC (Agatston score >or= 100) was recorded in 23.9% of the sample. The cortisol response group demonstrated a higher risk of significant CAC (odds ratio = 2.20, 95% CI, 1.39-3.47) after adjustments for age, gender, baseline cortisol, employment grade, and conventional risk factors, although cortisol was unrelated to the presence of detectable CAC. Among participants with detectable CAC, the cortisol response group also demonstrated higher log Agatston scores compared with non-responders (age and sex adjusted scores; 4.51 +/- 0.15 vs. 3.94 +/- 0.13, P = 0.004). CONCLUSION: In healthy, older participants without history or objective signs of CHD, heightened cortisol reactivity is associated with a greater extent of CAC. These data support the notion that heightened hypothalamic pituitary adrenal activity is a risk factor for CHD.
Hamer et al. (Thu,) conducted a cross-sectional in Healthy (no history or objective signs of coronary heart disease) (n=514). Cortisol response to mental stress (≥1 nmol/L increase) vs. Non-responders (no notable increase in cortisol) was evaluated on Significant coronary artery calcification (Agatston score ≥ 100) (OR 2.20, 95% CI 1.39-3.47). A notable cortisol response to mental stress was associated with a higher risk of significant coronary artery calcification in healthy adults (OR 2.20; 95% CI 1.39-3.47).