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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
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Published on: January 28, 2020

Circulating plasma cortisol concentrations are not associated with coronary artery disease or peripheral vascular

R M Reynolds1, B Ilyas, J F Price

  • 1Centre for Cardiovascular Sciences, University of Edinburgh, Queen's Medical Research Institute, Edinburgh, Scotland, UK. R.Reynolds@ed.ac.uk

QJM : Monthly Journal of the Association of Physicians
|May 22, 2009
PubMed

Insights

Basal cortisol levels do not reliably predict coronary artery disease or peripheral vascular disease. Further research into the hypothalamic-pituitary-adrenal (HPA) axis is needed to understand its role in atherosclerosis.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Metabolic Syndrome

Background:

  • The obesity epidemic and metabolic syndrome may counteract declining cardiovascular disease (CVD) rates.
  • The role of hypothalamic-pituitary-adrenal (HPA) axis activation and circulating cortisol in vascular disease pathogenesis remains unclear.
  • Conflicting previous studies highlight the need to differentiate basal cortisol from HPA axis responsiveness.

Purpose of the Study:

  • To investigate if basal circulating cortisol levels predict coronary artery disease (CAD) or peripheral vascular disease.
  • To assess the association between cortisol levels and vascular disease severity and symptoms.

Main Methods:

  • Basal plasma cortisol levels were measured in 278 subjects undergoing coronary angiography for suspected CAD.
  • Cortisol levels were also assessed in 76 cases and 85 controls with or without peripheral vascular disease.

Main Results:

  • Circulating cortisol levels showed a trend towards being lower in subjects with confirmed coronary vessel disease (P = 0.10) and those requiring intervention (P = 0.07).
  • Lower cortisol levels were significantly associated with increased angina symptoms (P = 0.01).
  • No significant difference in cortisol levels was observed between subjects with and without peripheral vascular disease.

Conclusions:

  • A single measurement of basal circulating cortisol is insufficient for predicting vascular disease.
  • Comprehensive characterization of the HPA axis, including its stress responsiveness, is crucial for understanding the role of glucocorticoids in atherosclerosis.
Abstract

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