Key result
Elevated hair cortisol concentration showed no clinically meaningful association with cardiac structure or function, with only a modest link to left atrial end-systolic volume index (β=0.178 SD).
Why the study?
Whether prolonged cortisol exposure reflected by elevated hair cortisol concentration is linked to alterations in cardiac structure and function remains unclear.
Does long-term cortisol exposure (elevated hair cortisol concentration) alter echocardiographic measures of cardiac structure and function in generally healthy middle-aged adults?
Cohort (n=3,005)
Does long-term cortisol exposure (elevated hair cortisol concentration) alter echocardiographic measures of cardiac structure and function in generally healthy middle-aged adults?
Effect estimate: β=0.178 SD
Long-term stress-induced cortisol exposure, assessed via hair cortisol concentration, does not have a clinically meaningful impact on cardiac structure or function in generally healthy middle-aged adults.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Although elevated hair cortisol has been associated with increased CVD risk, the present findings do not support a relationship with echocardiographic measures of cardiac structure or function in the studied population, suggesting that any such effects may be mediated through alternative physiological pathways.”
No clinically meaningful cardiac effects in healthy middle-aged adults; leaves open non-echocardiographic pathways for chronic stress-related CVD risk.
Background Chronic activation of the hypothalamic–pituitary–adrenal axis due to long-term stress, reflected by elevated hair cortisol concentration (HCC), has been associated with increased cardiovascular disease risk. However, whether prolonged cortisol exposure is linked to alterations in cardiac structure and function remains unclear. Methods In a population-based cohort of 3005 individuals aged 50–64 years in Sweden, HCC was measured and analysed in relation to 19 echocardiographic parameters reflecting cardiac morphology and function. Through linear regression models the association between HCC and echocardiographic parameters was analysed, adjusting for relevant confounders and complemented by sensitivity analyses to assess influence of extreme values and to evaluate potential non-linearity. Results No significant association between HCC and three broad principal component analysis-derived cardiac phenotypes was observed. Across 19 individual echocardiographic measures, effect estimates were generally small and CIs largely included the null. Left Atrial End-Systolic Volume Index (LAESVI) was the only measure showing a false discovery rate-adjusted significant association with HCC; however the magnitude of this association was modest, with β=0.178 SD per one-unit increase in log10-HCC, corresponding to approximately 0.734 mL/m² higher LAESVI across the IQR of HCC (~2.9% of the cohort median). Conclusions Taken together, in this population-based study, these findings provide little evidence that HCC is associated with clinically meaningful differences in cardiac structure or function in generally healthy middle-aged adults.
No takes yet. Share an insight, caveat, or question.
Söderholm et al. (2026) conducted a cohort in Generally healthy adults (n=3,005). Hair cortisol concentration (HCC) was evaluated on Echocardiographic parameters reflecting cardiac morphology and function (β=0.178 SD). Elevated hair cortisol concentration showed no clinically meaningful association with cardiac structure or function, with only a modest link to left atrial end-systolic volume index (β=0.178 SD).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: