Cortisol Responses to Mental Stress and Incident Hypertension in Healthy Men and Women
Cortisol Responses to Mental Stress and Incident Hypertension in Healthy Men and Women
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DOI：
10.1210/jc.2011-2132
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发表时间：
2012-01-01
影响因子：
5.8
通讯作者：
Steptoe, Andrew
中科院分区：
文献类型：
--
作者：
Hamer, Mark;Steptoe, Andrew
背景：心血管对精神压力源的反应增强与未来高血压的风险相关。皮质醇是一种由下丘脑-垂体-肾上腺轴产生的关键应激激素，其作用尚不清楚。目的：我们的目的是检查皮质醇对实验室诱导的精神压力和高血压事件的反应之间的关系。设计与背景：这是一项前瞻性的研究，对Whitehall II队列进行了3年的职业随访。参与者：参与者包括479名最初健康的男性和女性（平均年龄62.7±5.6岁），在研究开始时没有心血管疾病或高血压病史或客观迹象。干预：在基线评估时，测量唾液皮质醇对精神压力源的反应，包括5分钟的Stroop任务和5分钟的镜像追踪任务。主要结局指标：在研究开始时和3年随访时测量血压以确定高血压。结果：皮质醇应激反应存在相当大的差异，大约40%的样本对应激任务的皮质醇增加至少1 mmol/l。在3年的随访中，15.9%的样本患上了高血压。在调整了年龄、性别、静息皮质醇、研究开始时血压、工作等级、吸烟、体重指数、糖化血红蛋白、他汀类药物使用和血脂等因素后，皮质醇应激反应性（每SD）与高血压事件之间存在关联（优势比= 1.59；95%可信区间= 1.17-2.17）。结论：这些数据支持这样一种观点，即作为下丘脑-垂体-肾上腺功能指标的皮质醇反应性是社会心理压力影响高血压风险的可能机制之一。[J] .中华内分泌杂志，2012,31(5):379 - 379。
Context: 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.Design and Setting: This was a prospective substudy of the Whitehall II cohort with 3 years follow-up of an occupational cohort.Participants: 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.Intervention: 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.Main Outcome Measures: 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.Conclusion: 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. (J Clin Endocrinol Metab 97: E29-E34, 2012)