Why the study?
Chronic stress is linked to cardiometabolic diseases via increased glucocorticoid exposure, but the impact of daily life stress on glucocorticoid regulation and cardiometabolic health remains underexplored.
Are daily life stress (measured by the Daily Hassles Questionnaire) and glucocorticoid regulation (measured by salivary cortisol and low-dose dexamethasone suppression test) associated with cardiovascular disease and cardiometabolic health in adults without recent psychiatric diagnosis?
Are daily life stress (measured by the Daily Hassles Questionnaire) and glucocorticoid regulation (measured by salivary cortisol and low-dose dexamethasone suppression test) associated with cardiovascular disease and cardiometabolic health in adults without recent psychiatric diagnosis?
Increased daily life stress and higher cortisol suppression following a low-dose dexamethasone test (indicating increased glucocorticoid sensitivity) are independently associated with higher odds of cardiovascular disease via separate pathways.
Answers are grounded in this paper and cite their sources.
Should not yet change practice; leaves open independent daily-hassle and HPA-axis pathways to CVD.
OBJECTIVE: Chronic stress is linked to cardiometabolic diseases through increased glucocorticoid exposure, but the impact of daily life stress on glucocorticoid regulation and cardiometabolic health remains underexplored. This study investigated these associations. DESIGN: This is a cross-sectional analysis of participants from the Netherlands Study of Depression and Anxiety (NESDA) without psychiatric diagnosis in the prior 6 months. METHODS: We included 870 participants (64.7% female, median age 47.0 years). Daily life stress was assessed using the Daily Hassles Questionnaire (DHQ). Salivary cortisol was analyzed for 1-h awakening cortisol (4 time points), evening cortisol, and slope. Also an overnight 0.5 mg dexamethasone suppression test was performed. Associations between DHQ, glucocorticoid measures, and cardiometabolic health were studied using logistic and linear regressions. RESULTS: After multivariable adjustment, each standard deviation (SD) increase in DHQ score was associated with 1.38 times (95% confidence interval [CI] 1.07; 1.77) higher odds of cardiovascular disease (CVD), but not diabetes, metabolic syndrome, or obesity. Higher DHQ scores were also associated with higher evening cortisol levels. In addition, each SD increase in cortisol suppression ratio was associated with 1.36 times (95% CI 1.08; 1.72) higher odds of CVD, but not diabetes, metabolic syndrome, or obesity. No interactions between DHQ and glucocorticoid measures on CVD were observed. CONCLUSION: A higher cortisol suppression ratio, indicative of increased glucocorticoid sensitivity, and increased daily hassles were both independently associated with having CVD. The absence of interaction suggests they influence CVD through separate pathways, highlighting the need for further research to better understand stress mechanisms and identify "stress profiles" most closely linked to cardiometabolic diseases.
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Lengton et al. (2026) studied this question.
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