Cortisol activity partially accounts for a relationship between community socioeconomic position and atherosclerosis

Miller, Karissa G.; Gianaros, Peter J.; Kamarck, Thomas W.; Anderson, Barbara A.; Muldoon, Matthew F.; Manuck, Stephen B.

doi:10.1016/j.psyneuen.2021.105292

Cited by 3 publications

(7 citation statements)

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“…Two studies of participants around the ages of 40 (sample sizes 718 and 488) had previously found an association between a flatter cortisol slope and higher cIMT and risk of coronary artery calcification (CAC). 11,15 A study in 1866 older participants (mean 75 years) found AUC to be associated with a higher plaque score. 10 However, a study of 610 participants in the Multi-Ethnic Study of Atherosclerosis of similar age to our study found weak and directionally inconsistent associations between cortisol and two subclinical measure of atherosclerosis (CAC and brachial ankle index), 12 and a study of 367 women in the Coronary Artery Risk Development in Young Adults study found no association between AUC or slope and CAC or cIMT.…”

Section: Discussionmentioning

confidence: 99%

“…13 Apart from Dekker et al , 10 no other study found an association of CAR and AUC with measures of subclinical atherosclerosis. 11–13,15 A longitundinal study of 3281 participants of ∼65 years of age found no associations between salivary cortisol and PWV but observed that a more shallow salivary cortisol slope at baseline was associated with a greater change in PWV over the subsequent 5 years in women but not in men. 14 Hajat et al hypothesised that cortisol might be more relevant in the development of atherosclerosis at younger ages and of lesser importance in older age.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…However, available evidence on associations of salivary cortisol excursions and subclinical cardiovascular measures to date is inconclusive and has been limited to measures of atherosclerosis. [10][11][12][13][14][15] In this study we aimed to: (1) investigate the cross-sectional associations of diurnal patterns of salivary cortisol with multiple subclinical measures of cardiovascular disease; (2) investigate the prospective associations of diurnal salivary cortisol patterns with cardiovascular and non-cardiovascular mortality in participants of the MRC National Survey for Health and Development study (NSHD), aged 60-64 years at cortisol sampling. We hypothesised that HPA axis dysregulation would be associated with evidence of subclinical cardiovascular disease and cardiovascular mortality.…”

Section: Article 1 Introductionmentioning

confidence: 99%

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Associations of salivary cortisol with cardiovascular parameters and mortality in the MRC National Survey of Health and Development (NSHD)

Al Saikhan,

Williams,

Captur

et al. 2023

Preprint

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ObjectivesHypothalamic-pituitary-adrenal (HPA) dysregulation is a postulated risk factor for cardiovascular disease but results from previous studies have been mixed. We examined cross-sectional associations of diurnal patterns of salivary cortisol with 10 subclinical measures of cardiovascular disease (including pulse wave velocity, carotid intima-media thickness, and measures of heart structure and function), and prospective associations of cortisol variation with cardiovascular (CV) and non-cardiovascular (NCV) mortality.MethodsWe included up to 1,263 participants of the MRC National Survey for Health and Development birth cohort, who had participated in serial diurnal salivary cortisol sampling in 2006-2010 (aged 60–64 years). We used multivariable linear and multinomial logistic regression to estimate associations of cortisol awakening response (CAR), slope and area under the curve (AUC) with subclinical cardiovascular measures, and multivariable Cox regression to estimate associations of the three cortisol metrics with all-cause, CV and NCV mortality.ResultsAll associations with subclinical cardiovascular measures were weak and most were compatible with the null hypothesis. Each standard deviation (SD) higher cortisol AUC was associated with a 1.9% (95%-CI 0.3-3.5) higher pulse wave velocity. A shallow cortisol slope (per SD gradient) was associated with a 1.4% lower intima media thickness (95%-CI −2.6, − 0.2), and lower odds of concentric remodelling (OR 0.83, 95%-CI 0.70-0.99). Given the multiple analyses performed, these could be chance findings. AUC, cortisol slope and CAR were not convincingly associated with cardiovascular or total mortality, although the 95% confidence intervals of hazard ratio estimates were wide.ConclusionsThis study provides little evidence for clinically important associations of salivary cortisol and subclinical cardiovascular measures and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Article 1 Introductionmentioning

confidence: 99%

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Associations of salivary cortisol with cardiovascular parameters and mortality in the MRC National Survey of Health and Development (NSHD)

Al Saikhan,

Williams,

Captur

et al. 2023

Preprint

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“…However, despite this pattern of associations, some studies have been unable to confirm the implied race → environmental stress → cortisol pathway (Cohen et al, 2006; DeSantis et al, 2007; Martin et al, 2012). Moreover, only a handful of studies have explicitly tested the other underlying indirect path models being proposed—specifically, the environmental stressors → cortisol → CVD risk pathway (Kwok et al, 2022; K. G. Miller et al, 2021), the race → cortisol → CVD pathway (Allen et al, 2019), and the race → environmental stressors → CVD pathway (Troxel et al, 2003).…”

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confidence: 99%

Race, cortisol, and subclinical cardiovascular disease in 9- to 11-year-old children.

Gump¹,

Hruska²,

Heffernan³

et al. 2023

Health Psychology

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Background: Non-Hispanic Black Americans have a greater risk for certain subtypes of cardiovascular disease (CVD; e.g., stroke and heart failure) relative to non-Hispanic White Americans. Moreover, Black relative to White adults consistently show elevated cortisol, a CVD risk. The impact of race, environmental stress, and cortisol on subclinical CVD has yet to be fully researched in children. Method: We assessed diurnal salivary cortisol slopes and hair cortisol in a sample of 9-to 11-year-old children (N = 271; 54% female) with roughly half self-identifying as either Black (57%) or White (43%). Two subclinical CVD indicators were assessed: carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT). We assessed numerous environmental stress indicators. Results: After adjusting for covariates, we found that Black children had significantly flatter diurnal cortisol slopes, higher hair cortisol, and thicker IMT than White children. Significant pathways were found: race → salivary cortisol slope → cfPWV (effect = −0.059, 95% CI [−0.116, −0.002]) and race → hair cortisol → cIMT (effect = −0.008, [−0.016, −0.002]). Black children also experienced significantly more environmental stress than White children; however, only income inequality served as a significant indirect pathway from race to salivary cortisol (effect = 0.029, [0.003, 0.060]). Conclusions: Relative to White children, Black children had significantly greater hair cortisol and flatter diurnal slopes which, in turn, were associated with greater subclinical CVD. As suggested by a significant indirect pathway, income inequality might partially explain the race-cortisol association. Public Significance StatementNumerous health disparities continue to exist among Black Americans relative to White Americans, across the lifespan. Specifically, the present study considers racial differences in subclinical CVD in children, and the potential indirect path through differences in underlying cortisol (the "stress hormone").

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Special Issue: Social Determinants of Health: What we still need to know

Fagundes

Wu-Chung

Christian

2022

Psychoneuroendocrinology

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Cortisol activity partially accounts for a relationship between community socioeconomic position and atherosclerosis

Cited by 3 publications

References 56 publications

Associations of salivary cortisol with cardiovascular parameters and mortality in the MRC National Survey of Health and Development (NSHD)

Associations of salivary cortisol with cardiovascular parameters and mortality in the MRC National Survey of Health and Development (NSHD)

Race, cortisol, and subclinical cardiovascular disease in 9- to 11-year-old children.

Special Issue: Social Determinants of Health: What we still need to know

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