TY - JOUR
T1 - Dysregulated diurnal cortisol patterns are associated with cardiovascular mortality
T2 - Findings from the KORA-F3 study
AU - Karl, Sebastian
AU - Johar, Hamimatunnisa
AU - Ladwig, Karl-Heinz
AU - Peters, Annette
AU - Lederbogen, Florian
N1 - Funding Information:
The KORA study was initiated and financed by the Helmholtz Zentrum M?nchen ? German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria.
Funding Information:
The KORA study was initiated and financed by the Helmholtz Zentrum München – German Research Center for Environmental Health , which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/7
Y1 - 2022/7
N2 - Psychosocial stress has been associated with an increased risk for cardiovascular disease and death. Dysregulated diurnal cortisol slopes, which have also been associated with stress, might mediate this association. However, existing evidence on the cardiovascular health consequences of dysregulated cortisol slopes remains limited and inconclusive. To elucidate whether dysregulated diurnal cortisol slopes are related to cardiovascular mortality, we assessed salivary cortisol and cardiovascular morbidity and mortality in 1090 participants from the KORA-F3 study, a prospective, observational cohort study of a random representative sample from the general population. Eighty-seven deaths were registered during the mean follow-up period of approximately 11 years, 31 of which were classified as cardiovascular deaths. A more pronounced cortisol awakening response was associated with a lower risk of cardiovascular mortality in the adjusted Cox proportional hazards analysis (HR 0.59 [95-%-CI 0.36–0.96], p = 0.03). A greater diurnal cortisol peak-to-bedtime ratio at baseline also predicted a decreased risk of cardiovascular mortality (HR 0.50 [95-%-CI 0.34–0.73], p 0.01) and a decreased risk of stroke (HR 0.71 [95-%-CI 0.55–0.92], p 0.01). Increased levels of late night salivary cortisol predicted a higher risk of cardiovascular mortality (HR 1.49 [95-%-CI 1.13–1.97], p 0.01) and an increased risk of stroke (HR 1.24 [95-%-CI 1.01–1.52], p = 0.04). There was no association between measures of cortisol and non-cardiovascular related mortality. In conclusion, dysregulated diurnal cortisol patterns are associated with cardiovascular mortality, while greater diurnal cortisol variation seems to have a protective effect. This adds evidence to suggest a pathophysiological role of diurnal cortisol secretion patterns in cardiovascular health.
AB - Psychosocial stress has been associated with an increased risk for cardiovascular disease and death. Dysregulated diurnal cortisol slopes, which have also been associated with stress, might mediate this association. However, existing evidence on the cardiovascular health consequences of dysregulated cortisol slopes remains limited and inconclusive. To elucidate whether dysregulated diurnal cortisol slopes are related to cardiovascular mortality, we assessed salivary cortisol and cardiovascular morbidity and mortality in 1090 participants from the KORA-F3 study, a prospective, observational cohort study of a random representative sample from the general population. Eighty-seven deaths were registered during the mean follow-up period of approximately 11 years, 31 of which were classified as cardiovascular deaths. A more pronounced cortisol awakening response was associated with a lower risk of cardiovascular mortality in the adjusted Cox proportional hazards analysis (HR 0.59 [95-%-CI 0.36–0.96], p = 0.03). A greater diurnal cortisol peak-to-bedtime ratio at baseline also predicted a decreased risk of cardiovascular mortality (HR 0.50 [95-%-CI 0.34–0.73], p 0.01) and a decreased risk of stroke (HR 0.71 [95-%-CI 0.55–0.92], p 0.01). Increased levels of late night salivary cortisol predicted a higher risk of cardiovascular mortality (HR 1.49 [95-%-CI 1.13–1.97], p 0.01) and an increased risk of stroke (HR 1.24 [95-%-CI 1.01–1.52], p = 0.04). There was no association between measures of cortisol and non-cardiovascular related mortality. In conclusion, dysregulated diurnal cortisol patterns are associated with cardiovascular mortality, while greater diurnal cortisol variation seems to have a protective effect. This adds evidence to suggest a pathophysiological role of diurnal cortisol secretion patterns in cardiovascular health.
KW - Cardiovascular
KW - Cortisol awakening response
KW - Diurnal cortisol slope
KW - Mortality
KW - Myocardial infarction
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85127527361&partnerID=8YFLogxK
U2 - 10.1016/j.psyneuen.2022.105753
DO - 10.1016/j.psyneuen.2022.105753
M3 - Article
C2 - 35395560
AN - SCOPUS:85127527361
SN - 0306-4530
VL - 141
JO - Psychoneuroendocrinology
JF - Psychoneuroendocrinology
M1 - 105753
ER -