The association between cortisol response to mental stress and high-sensitivity cardiac troponin T plasma concentration in healthy adults.
J Am Coll Cardiol. 2013 Jun 26;
Authors: Lazzarino AI, Hamer M, Gaze D, Collinson P, Steptoe A
OBJECTIVES: To examine the association between cortisol response to mental stress and high-sensitivity cardiac Troponin T in healthy older individuals without history of cardiovascular disease (CVD).
BACKGROUND: Mental stress is a recognized risk factor for CVD, although the mechanisms remain unclear. Cortisol, a key stress hormone, is associated with coronary atherosclerosis, and may accentuate structural and functional cardiac disease.
METHODS: This cross-sectional study involved 508 disease-free men and women aged 53-76 drawn from the Whitehall II epidemiological cohort. We evaluated salivary cortisol response to standardized mental stress tests (exposure) and cardiac Troponin T plasma concentration using a high-sensitivity assay (outcome). We measured coronary calcification using electron-beam dual-source computerized tomography and Agatston scores.
RESULTS: After adjustment for demographic and clinical variables associated with CVD as well as for inflammatory factors, we found a robust association between cortisol response and detectable HS-CTnT (odds ratio [OR] =3.98; 95%CI =1.60-9.92; P =0.003). The association remained when we restricted the analysis to participants without coronary calcification (N =222; OR =4.77; 95%CI =1.22-18.72; P =0.025), or when we further adjusted for coronary calcification in participants with positive Agatston scores (N =286; OR =7.39; 95%CI =2.22-26.24; P =0.001).
CONCLUSIONS: We found that heightened cortisol response to mental stress is associated with detectable plasma levels of cardiac troponin T using high-sensitivity assays in healthy participants, independently of coronary atherosclerosis. Further research is needed to understand the role of psychosocial stress in the pathophysiology of cardiac cell damage.
PMID: 23810896 [PubMed - as supplied by publisher]