Robin Lengton1, Mariëtte R. Boon1, Susanne Kuckuck1, Johanneke E. Oosterman1, Brenda W.J.H. Penninx2, Elisabeth F.C. van Rossum1
1Obesity Center CGG, Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
2Department of Psychiatry and Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
Background:
Chronic stress, characterized by increased hair glucocorticoid levels, is associated with cardiovascular disease (CVD). Whether this also accounts for daily life stress is unknown. Although chronic stress impacts various glucocorticoid measures (e.g. cortisol awakening response and glucocorticoid sensitivity), for daily life stress this is much less clear. Therefore, we investigated the association between daily life stress and various glucocorticoid measures and subsequently the risk with CVD in the general population.
Methods:
In total, 478 participants were included (59.8% female, mean age = 45.0 years) without lifetime psychiatric disorders from the Netherlands Study of Depression and Anxiety (NESDA). Daily life stress was measured using the Daily Hassles questionnaire (score range 0-60). Seven salivary samples were collected and analyzed for cortisol, providing information on 1-h awakening cortisol, diurnal slope and evening cortisol. Also a dexamethasone (0.5 mg) suppression test (DST) was performed. Associations between daily life stress, glucocorticoid measures, and CVD were studied by logistic and linear regression analyses, adjusted for potential baseline confounders.
Results:
After multivariable adjustment, each 1-point increase in Daily Hassles score was associated with 0.93% (95%CI 0.00;1.86%) increase in cortisol suppression ratio after DST. No associations were found with other glucocorticoid measures. In addition, each 1-point increase in Daily Hassles score was associated with 1.09-fold (95%CI 1.02;1.16) increased odds for CVD. Moreover, each 1-point increase in cortisol suppression ratio after DST was associated with 1.39-fold (95%CI 1.16;1.68) increased odds for CVD.
Discussion/Conclusion:
Daily life stress is associated with increased CVD risk in the population. Furthermore, daily life stress is associated with increased sensitivity to glucocorticoids, as measured by lower cortisol levels after low dose DST. Interestingly, this increased cortisol sensitivity is associated with higher prevalence of CVD. Additional analyses are in progress to investigate whether the association between daily life stress and CVD is mediated by glucocorticoid regulation.
- Conflicts of interest:
All authors declare that they have no conflict of interest.
- Funding:
This work is funded by Stress in Action. The research project ‘Stress in Action’: www.stress-in-action.nl is financially supported by the Dutch Research Council and the Dutch Ministry of Education, Culture and Science (NWO gravitation grant number 024.005.010). EFCvR is also supported by a Vidi grant from the Netherlands Organization of Scientific Research NWO (grant number: 91716453) and funded by the Elisabeth Foundation.