title: Effects of short-term glucocorticoids on cardiovascular biomarkers.
abstract: BACKGROUND
  Glucocorticoids are known to acutely increase blood pressure, suppress inflammation, and precipitate insulin resistance. However, the short-term effects of glucocorticoids on other cardiovascular risk factors remain incompletely characterized.
  
  
  OBJECTIVE
  Our objective was to determine the effects of a short course of dexamethasone on multiple cardiovascular biomarkers and to determine whether suppression of morning cortisol in response to low-dose dexamethasone is correlated with cardiovascular risk markers in healthy volunteers.
  
  
  METHODS
  We conducted a randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  The study took place in a tertiary care hospital.
  
  
  METHODS
  Twenty-five healthy male volunteers, ages 19-39 yr, participated in the study.
  
  
  METHODS
  Subjects received either 3 mg dexamethasone twice daily or placebo for 5 d. Subjects also underwent a low-dose (0.5 mg) overnight dexamethasone suppression test.
  
  
  METHODS
  Parameters examined before and after the 5-d intervention included heart rate, blood pressure, weight, fasting lipid variables, homocysteine, renin, aldosterone, insulin resistance (homeostasis model assessment), high-sensitivity C-reactive protein, B-type natriuretic peptide, flow-mediated and nitroglycerin-mediated brachial artery dilatation, and heart rate recovery after exercise. All measurements were done in the morning hours in the fasting state.
  
  
  RESULTS
  Dexamethasone increased systolic blood pressure, weight, B-type natriuretic peptide, and high-density-lipoprotein-cholesterol. Dexamethasone decreased resting heart rate, high-sensitivity C-reactive protein, and aldosterone and tended to attenuate nitroglycerin-mediated vasodilatation. There was no effect on flow-mediated vasodilatation, diastolic blood pressure, triglycerides, low-density-lipoprotein-cholesterol, nonesterified fatty acids, homocysteine, or heart rate recovery. The response of circulating cortisol to low-dose dexamethasone had no significant correlation with any of the cardiovascular risk markers.
  
  
  CONCLUSIONS
  Short-term glucocorticoids elicits both favorable and unfavorable effects on different cardiovascular risk factors. Manipulation of specific glucocorticoid-responsive physiological pathways deserves further study.
authors.affiliation: Department of General Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. dbrotma1@jhmi.edu
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Brotman
authors.forename: John P
authors.initials: JP
authors.lastname: Girod
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Garcia
authors.forename: Jeetesh V
authors.initials: JV
authors.lastname: Patel
authors.forename: Manjula
authors.initials: M
authors.lastname: Gupta
authors.forename: Amy
authors.initials: A
authors.lastname: Posch
authors.forename: Sue
authors.initials: S
authors.lastname: Saunders
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.forename: Sarah
authors.initials: S
authors.lastname: Worley
authors.forename: Sethu
authors.initials: S
authors.lastname: Reddy
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight; D001916:Brachial Artery / Q000187:drug effects / Q000502:physiology; D002319:Cardiovascular System / Q000187:drug effects*; D003907:Dexamethasone / Q000494:pharmacology*; D004311:Double-Blind Method; D005938:Glucocorticoids / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects; D008297:Male; D010919:Placebos
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D008055:Lipids; D008074:Lipoproteins; D010919:Placebos; D003907:Dexamethasone