Cortisol responses to mental stress and incident hypertension in healthy men and women.
BACKGROUND
Heightened cardiovascular responses to mental stressors are associated with future risk of hypertension. The role of cortisol, a key stress hormone produced by the hypothalamic-pituitary-adrenal axis, remains unclear.


OBJECTIVE
Our objective was to examine the association between cortisol responses to laboratory-induced mental stress and incident hypertension.


METHODS
This was a prospective substudy of the Whitehall II cohort with 3 years follow-up of an occupational cohort.


METHODS
Participants included 479 initially healthy men and women (mean age, 62.7 ± 5.6 yr), without history or objective signs of cardiovascular disease or hypertension at study entry.


METHODS
At the baseline assessment, salivary cortisol was measured in response to mental stressors, consisting of a 5-min Stroop task and a 5-min mirror tracing task.


METHODS
Blood pressure was measured at study entry and at 3 yr follow-up for the determination of hypertension.


RESULTS
There was considerable variation in the cortisol stress response, with approximately 40% of the sample responding to the stress tasks with an increase in cortisol of at least 1 mmol/liter. Over the 3 yr follow-up, 15.9% of the sample developed hypertension. There was an association between cortisol stress reactivity (per sd) and incident hypertension (odds ratio = 1.59; 95% confidence interval = 1.17-2.17) after adjustments for age, sex, resting cortisol, blood pressure at study entry, employment grade, smoking, body mass index, glycated hemoglobin, use of statins, and blood lipids.


CONCLUSIONS
These data support the notion that cortisol reactivity, an index of hypothalamic-pituitary-adrenal function, is one of the possible mechanisms through which psychosocial stress may influence the risk of hypertension.
Department of Epidemiology and Public Health, 1-19 Torrington Place, University College London, London WC1E 6BT UK. m.hamer@ucl.ac.uk
Mark
M
Hamer
Andrew
A
Steptoe
D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006262:Health; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000378:metabolism; D006973:Hypertension / Q000097:blood / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000378:metabolism / Q000503:physiopathology; D011581:Psychological Tests; D013315:Stress, Psychological / Q000097:blood* / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology
D006854:Hydrocortisone