Salivary cortisol responses to mental stress are associated with coronary artery calcification in healthy men and women

Hamer, Mark; O’Donnell, Katie; Lahiri, Avijit; Steptoe, Andrew

doi:10.1093/eurheartj/ehp386

Cited by 116 publications

(101 citation statements)

References 43 publications

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“…Neither association was significant in women (Table S2). The laboratory stress protocol elicited small but significant salivary cortisol responses, as described previously (29). We found that responses to stress varied across telomere groups in men (P = 0.02) but not women.…”

Section: Resultssupporting

confidence: 78%

Shorter telomeres with high telomerase activity are associated with raised allostatic load and impoverished psychosocial resources

Zalli

Carvalho

Lin

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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Recent work has linked psychological stress with premature cellular aging as indexed by reduced leukocyte telomere length. The combination of shorter telomeres with high telomerase activity (TA) may be indicative of active cell stress. We hypothesized that older individuals characterized by shorter telomeres with high TA in unstimulated leukocytes would show signs of high allostatic load and low levels of protective psychosocial resources. We studied 333 healthy men and women aged 54-76 y who underwent laboratory testing in which we measured cardiovascular, neuroendocrine, and inflammatory responses to standardized mental stress tasks. The tasks elicited prompt increases in blood pressure (BP), heart rate, cortisol, and mediators of inflammation and reductions in heart rate variability, returning toward baseline levels following stress. However, men having shorter telomeres with high TA showed blunted poststress recovery in systolic BP, heart rate variability, and monocyte chemoattractant protein-1, together with reduced responsivity in diastolic BP, heart rate, and cortisol, in comparison to men with longer telomeres or men with shorter telomeres and low TA. Shorter telomeres with high TA were also associated with reduced social support, lower optimism, higher hostility, and greater early life adversity. These effects were independent of age, socioeconomic status, and body mass index. We did not observe differences among older women. Our findings suggest that active cell stress is associated with impaired physiological stress responses and impoverished psychosocial resources, reflecting an integration of cellular, systemic, and psychological stress processes potentially relevant to health in older men. cellular senescence | allostasis | psychological distress T elomeres are nucleoprotein structures composed of tandem hexanucleotide repeats of the sequence TTAGGG that cap the ends of eukaryotic chromosomes, protecting them from end-to-end fusion and degradation during cell division. Human telomeric DNA naturally shortens with age during somatic cell divisions and as a result of oxidative attack (1, 2). At critical shortness, telomeres exhibit impaired function, leading to genomic instability, apoptosis, and cell senescence, often with altered transcriptional programming and mitochondrial dysfunction (1). Telomere attrition represents one of the hallmarks of aging (3). In humans, Mendelian singlegene mutations that directly compromise telomere maintenance cause premature mortality and onset of a spectrum of diseases overlapping with the age-related diseases common in the population (4). In addition, genome-wide association studies show that certain combinations of SNPs at genetic loci encoding known telomere-maintenance factors are associated with increased relative risks for pulmonary and coronary diseases (5). Shorter telomere length (TL) in white blood cells is linked and, in some cases, anticipates aging-related morbidity and mortality from conditions with immune system involvement, such as infectious disease...

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Section: Resultssupporting

confidence: 78%

Shorter telomeres with high telomerase activity are associated with raised allostatic load and impoverished psychosocial resources

Zalli

Carvalho

Lin

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

Self Cite

157

113

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“…Healthy participants drawn from the Whitehall II epidemiological cohort [21] were invited to take part in a parent study examining the role of psychophysiologic factors in CVD risk [22]. Exclusion criteria included objective signs of clinical or subclinical CVD, cancer treatment in the past 5 years, regular use of prescribed medications (excluding statins), current hypertension, any inflammatory or autoimmune conditions, and diagnosed mental health disorders.…”

Section: Participants' Characteristicsmentioning

confidence: 99%

“…Mental stress was elicited using two previously described standardized tasks administered under time pressure that reliably perturbs the cardiovascular and immune system [22,23]. Briefly, in the mirror tracing task, participants were required to trace the narrow contour of a star using an electronic stylus while looking at the star's reflection in a mirror.…”

Section: Acute Mental Stressmentioning

confidence: 99%

Post-menopausal Women Exhibit Greater Interleukin-6 Responses to Mental Stress Than Older Men

2016

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Background Acute stress triggers innate immune responses and elevation in circulating cytokines including interleukin-6 (IL-6). The effect of sex on IL-6 responses remains unclear due to important limitations of previous studies. Purpose The purpose of this study was to examine sex differences in IL-6 responses to mental stress in a healthy, older (postmenopausal) sample accounting for several moderating factors. Methods Five hundred six participants (62.9 ± 5.60 years, 55 % male) underwent 10 min of mental stress consisting of mirror tracing and Stroop task. Blood was sampled at baseline, after stress, and 45 and 75 min post-stress, and assayed using a high sensitivity kit. IL-6 reactivity was computed as the mean difference between baseline and 45 min and between baseline and 75 min post-stress. Main effects and interactions were examined using ANCOVA models. Results There was a main effect of time for the IL-6 response (F 3,1512 = 201.57, p = <.0001) and a sex by time interaction (F 3,1512 = 17.07, p = <.001). In multivariate adjusted analyses, IL-6 reactivity was significantly greater in females at 45 min (M = 0.37 ± 0.04 vs. 0.20 ± 0.03 pg/mL, p = .01) and at 75 min (M = 0.57 ± 0.05 vs. 0.31 ± 0.05 pg/mL, p = .004) post-stress compared to males. Results were independent of age, adiposity, socioeconomic position, depression, smoking and alcohol consumption, physical activity, statin use, testing time, task appraisals, hormone replacement, and baseline IL-6. Other significant predictors of IL-6 reactivity were lower household wealth, afternoon testing, and baseline IL-6. Conclusions Healthy, post-menopausal females exhibit substantially greater IL-6 responses to acute stress. Inflammatory responses if sustained over time may have clinical implications for the development and maintenance of inflammatoryrelated conditions prevalent in older women.

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“…Both tests have been used extensively in psychophysiological research. 24,25 Each task lasted for 1 min, followed by a 15-min recovery. Beat-to-beat BP was continuously assessed throughout psychophysiological testing using the Finometer device.…”

Section: Blood Pressure Measurementsmentioning

confidence: 99%

Blood pressure variability is significantly associated with ECG left ventricular mass in normotensive Africans: The SABPA Study

Schutte

Huisman

et al. 2011

Hypertens Res

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The prognostic significance of blood pressure (BP) variability has lately enjoyed considerable attention. The need for early markers of cardiovascular dysfunction is imperative in black South Africans who have a significant risk for cardiovascular disease. We therefore compared 24-h BP variability with various traditional and advanced BP measurements, regarding their association with sub-clinical organ damage in black and white South Africans. The study included 409 African and Caucasian teachers aged 25-60 yrs. We measured office BP, 1-min continuous (finger) BP, ambulatory BP, BP reactivity and determined weighted 24-h BP variability. Albumin-to-creatinine ratio, Cornell product and carotid cross-sectional wall area (CSWA) were measures of organ damage. Africans had higher 24-h BP, BP variability, BP reactivity and sub-clinical organ damage (Po0.001). Correlations of BP variability with organ damage were overall weak when compared with other BP measurements. In normotensive groups, we found an independent association of 24-h systolic BP (SBP) variability with Cornell product only in Africans (r¼0.37; P¼0.01), confirmed in multiple regression models, with 24-h SBP included in the model. Only in hypertensive Caucasians, a significant correlation between CSWA and 24-h SBP variability was evident (r¼0.30; P¼0.01), although CSWA indicated stronger correlations with office or 24-h SBP than 24-h SBP variability. To conclude, 24-h SBP variability could potentially be an effective measure for the early detection of normotensive Africans at increased risk for the development of cardiovascular complications. Its usefulness based on associations with target organ damage in hypertensive groups seems to be less than traditional office or 24-h BP measurements. Hypertension Research (2011Research ( ) 34, 1127Research ( -1134 doi:10.1038/hr.2011; published online 28 July 2011Keywords: albumin-to-creatinine ratio; ethnicity; intima-media thickness; left ventricular hypertrophy INTRODUCTIONThe prognostic significance of blood pressure (BP) variability has lately enjoyed considerable attention in the literature. [1][2][3][4][5][6][7][8][9][10] Where some papers emphasize the importance of BP variability in prediction of risk of vascular events, 1,2,6,9 others question its prediction of cardiovascular outcome. 4,5,10 Despite this upsurge of recent papers, consistent evidence over the past three decades lends support that both target organ damage and the rate of cardiovascular events of hypertensive patients are significantly and independently related to the degree of BP variability. [11][12][13][14][15] A limitation of many of these papers is that either BP variability alone was investigated, or various measures of BP variability (such as s.d. of 24-h BP, average real variability index 16 and weighted 24-h BP s.d. 17 ) were being compared, regarding the strength of their association with target organ damage.The question therefore arises how BP variability would benchmark against a comprehensive range of both traditional and advanced

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Salivary cortisol responses to mental stress are associated with coronary artery calcification in healthy men and women

Abstract: In healthy, older participants without history or objective signs of CHD, heightened cortisol reactivity is associated with a greater extent of CAC. These data support the notion that heightened hypothalamic pituitary adrenal activity is a risk factor for CHD.

Cited by 116 publications

References 43 publications

Shorter telomeres with high telomerase activity are associated with raised allostatic load and impoverished psychosocial resources

Shorter telomeres with high telomerase activity are associated with raised allostatic load and impoverished psychosocial resources

Post-menopausal Women Exhibit Greater Interleukin-6 Responses to Mental Stress Than Older Men

Blood pressure variability is significantly associated with ECG left ventricular mass in normotensive Africans: The SABPA Study

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