High stress hormone levels linked to increased cardiovascular mortality

High levels of the stress hormone cortisol strongly predict cardiovascular death among both persons with and without pre-existing cardiovascular disease according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

In stressful situations, the body responds by producing the hormone cortisol. The effects of cortisol are intended to help the body recover from stress and regain a status of homeostasis, however chronically elevated cortisol levels have been associated with cardiovascular risk factors, such as the metabolic syndrome and accelerated atherosclerosis.

“Previous studies have suggested that cortisol might increase the risk of cardiovascular mortality, but until now, no study had directly tested this hypothesis,” said Nicole Vogelzangs, PhD, of VU University Medical Center in The Netherlands and lead author of the study. “The results of our study clearly show that cortisol levels in a general older population predict cardiovascular death, but not other causes of mortality.”

In this study, researchers evaluated 861 people aged 65 years and older who participated in a prospective cohort study. Within six years of the beginning of the study 183 participants had died. Urinary cortisol levels of subjects were measured at the beginning of the study and cause of death was ascertained from death certificates. Researchers found that urinary cortisol did not increase the risk of non-cardiovascular mortality but did increase cardiovascular mortality risk. The third of the subjects with the highest urinary cortisol had a five-fold increased risk of dying of cardiovascular disease.

“Cortisol is an important component of the stress system of the human body but in higher concentrations can be harmful,” said Vogelzangs. “Our study shows that older persons with high levels of cortisol have an increased risk of dying from cardiovascular disease. This finding significantly adds evidence to the belief that cortisol can be damaging to the cardiovascular system.”

Other researchers working on the study include: Aartjan Beekman and Brenda Penninx of VU University Medical Center in The Netherlands; Yuri Milaneschi and Luigi Ferrucci of the National Institute on Aging in Baltimore, Md.; and Stefania Bandinelli of Azienda Sanitaria Firenze in Italy.

The article, “Urinary cortisol and six-year risk of all-cause and cardiovascular mortality,” will appear in the November 2010 issue of JCEM.

Founded in 1916, The Endocrine Society is the world's oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society and the field of endocrinology, visit our site at www.endo-society.org.