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Updated: Oct 17, 2025

Extraction and Analysis of Cortisol from Human and Monkey Hair
Published on: January 24, 2014
The association between chronic stress, hair cortisol, and angiographically documented coronary atherosclerosis, a
Asma Nafisa1, Feroza Hamid Wattoo1, Mazhar Qayyum2
1University Institute of Biochemistry and Biotechnology, PMAS-Arid Agriculture University, Rawalpindi, Pakistan.
Insights
Elevated hair cortisol concentration (HCC) is linked to coronary atherosclerosis. Higher HCC correlates with obesity and diabetes, identifying it as a significant predictor of this cardiovascular disease.
Area of Science:
- Endocrinology
- Cardiology
- Psychoneuroimmunology
Background:
- Cardiovascular diseases are a leading cause of global mortality.
- Chronic stress is a significant prognostic factor for cardiovascular diseases.
- Hair cortisol concentration (HCC) offers a long-term measure of cortisol exposure.
Purpose of the Study:
- To measure hair cortisol concentration (HCC) in patients with coronary atherosclerosis.
- To investigate the association between HCC and cardiovascular risk factors.
- To determine if HCC is an independent predictor of coronary atherosclerosis.
Main Methods:
- A case-control study involving 500 patients with coronary atherosclerosis and 500 matched controls.
- Hair cortisol concentration assessed using ELISA from scalp hair samples.
- Correlation and multivariate regression analyses to evaluate associations with risk factors and predictive value.
Main Results:
- Median HCC was significantly higher in patients with coronary atherosclerosis compared to controls.
- HCC positively correlated with Body Mass Index (BMI) and HbA1c.
- Multivariate analysis confirmed HCC as a significant independent predictor of coronary atherosclerosis.
Conclusions:
- Elevated hair cortisol concentration is associated with coronary atherosclerosis.
- HCC is a valuable biomarker for assessing chronic stress in cardiovascular disease risk.
- Further research is warranted to explore the therapeutic implications of managing stress-related cortisol levels.
Abstract:
Cardiovascular diseases remain the principal contributor to global mortality and morbidity. Chronic stress has emerged as a strong prognostic factor for cardiovascular diseases. We aimed to measure hair cortisol concentration (HCC) in patients with angiographically confirmed coronary atherosclerosis and find the association between HCC and classic cardiovascular risk factors in a case-control study. The study included 500 angiographically confirmed coronary atherosclerosis patients and 500 age and sex-matched controls having no coronary stenosis. Hair cortisol concentration was assessed from a single sample of scalp hair by ELISA. Perceived stress scale 10 was used to evaluate the stress level of the participants. Spearman rank correlation was applied to find the association between hair cortisol level and classic cardiovascular risk factors. Multivariate regression was executed to assess the independent contribution of hair cortisol concentration as a coronary atherosclerosis risk factor. Median hair cortisol concentration was significantly high in patients with angiographically documented coronary atherosclerosis compared to controls (158(17.6-1331.3) pg/mg versus 73 (13.4-889) pg/mg. Hair cortisol concentration showed a significant positive correlation with BMI r = 525 and Hb1Ac r = 665 (both, p = ≤0.0001). In multivariate logistic regression analysis after adjusting for all the confounding variables, HCC, matched odds ratio (MOR), 10.73;95%CI (1.60,42.09) p-value = 0.001 remained the most significant predictor of coronary atherosclerosis.LAY SUMMARYHair cortisol concentrations (HCC) were significantly high in patients with angiographically confirmed coronary atherosclerosis compared to controls. HCC showed a significant positive correlation with diabetes and obesity and remained a major predictor of coronary atherosclerosis in the final analysis.
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