[Dysfunction of the hypothalamus-pituitary-adrenal system--background variable of relevant cardiovascular risk...

The present project is based on findings showing that important risk factors for the development of coronary heart disease are frequently associated with a dysregulation in stress-responsive systems. Accordingly, the observed dysfunction in these systems might represent a background variable with a significant effect on the development and course of coronary heart disease. Examining a random population sample we aim at testing the hypothesis whether cardiac risk factors such as arterial hypertension, type 2 diabetes, visceral obesity and depression might be associated with a dysfunction in a major stress-responsive system, namely the hypothalamic-pituitary-adrenal (HPA) system. Assessment of the functional status of this system will be carried out by measuring cortisol concentrations in saliva at four set measurement times throughout a normal day while subjects continue to carry out their usual activities. This methodology enables us to characterize HPA system activity with regard to basal tone, reactivity to a specific stressor, circadian rhythm and overall activity. Our study population includes 1250 subjects aged 50 to 70 years taken from a representative sample of the general public of the city of Augsburg, Germany (KORA F3). Through close cooperation within the framework of the present project we will be able to examine neuroendocrine issues in association with detailed demographic and clinical data of a representative population sample.