Key result
Anxiety in moderately depressed CAD patients was associated with a significantly steeper 30-minute cortisol increase, higher AUCi, and lower waking and late-night cortisol levels.
Why the study?
Data on anxiety and cortisol output in coronary artery disease patients are scarce.
Does anxiety alter the cortisol awakening reaction in moderately depressed patients with coronary artery disease?
Cross-Sectional (n=77)
Does anxiety alter the cortisol awakening reaction in moderately depressed patients with coronary artery disease?
In moderately depressed CAD patients, comorbid anxiety is associated with a more dynamic cortisol reactivity pattern, which may represent a biological substrate of affect regulation linking psychosocial distress to cardiovascular risk.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for HPA dysregulation in anxious depressed CAD; prospective studies needed before clinical implications.
Disturbances of HPA axis functioning as represented by cortisol awakening reaction (CAR) belong to the mediating pathways linking psychosocial distress and cardiovascular risk. Both depression and anxiety have been confirmed as independent risk factors for coronary artery disease (CAD). However, data on anxiety and cortisol output in CAD patients are scarce. Based on previous data, we hypothesized that anxiety would be associated with higher cortisol output and a more pronounced morning increase in moderately depressed CAD patients. 77 patients (60 y, 79% male) underwent saliva sampling (+0, +30, +45, +60 min after awakening, midday and late-night sample). Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS) and patients were grouped into anxious versus non anxious subjects based upon the recommended score (≥11). A repeated measures ANOVA yielded a significant time and quadratic time effect referring to the typical CAR. Anxious patients showed a significantly steeper 30 min increase, higher AUCi, lower waking and late-night cortisol levels. The steeper cortisol increase in the anxious group is in line with previous data and may be interpreted as a biological substrate of affect regulation. The lower basal and late-night levels coupled with greater AUCi mirror a more dynamic reactivity pattern compared to depressed subjects without anxiety.
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Weber et al. (2022) conducted a cross-sectional in Moderately depressed coronary artery disease (CAD) (n=77). Anxiety (HADS score ≥11) vs. Non-anxious subjects (HADS score <11) was evaluated on Cortisol awakening reaction (CAR) including 30 min increase, AUCi, waking and late-night cortisol levels. Anxiety in moderately depressed CAD patients was associated with a significantly steeper 30-minute cortisol increase, higher AUCi, and lower waking and late-night cortisol levels.
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