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Race, cortisol, and subclinical cardiovascular disease in 9- to 11-year-old children

Brooks B Gump1, Bryce Hruska1, Kevin Heffernan2

  • 1Department of Public Health, Syracuse University.

Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association
|July 6, 2023
PubMed

Insights

Black children show higher cortisol levels and flatter diurnal cortisol slopes, linked to increased subclinical cardiovascular disease (CVD). Income inequality may partly explain these race-related differences in cortisol and CVD risk.

Area of Science:

  • Pediatric Health
  • Endocrinology
  • Cardiovascular Disease Research

Background:

  • Non-Hispanic Black Americans face higher risks for cardiovascular disease (CVD) subtypes like stroke and heart failure compared to non-Hispanic White Americans.
  • Elevated cortisol levels, a known CVD risk factor, are consistently observed in Black adults relative to White adults.
  • The interplay of race, environmental stress, and cortisol on subclinical CVD in children remains under-researched.

Purpose of the Study:

  • To investigate the association between race, diurnal salivary cortisol, hair cortisol, and subclinical CVD indicators in children.
  • To examine the role of environmental stress in mediating the relationship between race and cortisol levels.
  • To explore potential pathways linking race, cortisol, and subclinical CVD in a pediatric population.

Main Methods:

  • Assessed diurnal salivary cortisol slopes and hair cortisol in 271 children aged 9-11 years (57% Black, 43% White).
  • Measured two subclinical CVD indicators: carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT).
  • Collected data on various environmental stress indicators, including income inequality.

Main Results:

  • Black children exhibited significantly flatter diurnal cortisol slopes and higher hair cortisol compared to White children.
  • Higher hair cortisol and flatter diurnal cortisol slopes were associated with increased subclinical CVD indicators (cIMT and cfPWV, respectively).
  • Significant pathways identified: race → salivary cortisol slope → cfPWV and race → hair cortisol → cIMT. Income inequality was a significant indirect pathway from race to salivary cortisol.

Conclusions:

  • Black children display higher hair cortisol and flatter diurnal cortisol slopes, which are linked to greater subclinical CVD.
  • Findings suggest that race is associated with physiological stress markers and subclinical CVD in children.
  • Income inequality may partially mediate the observed race-cortisol association, highlighting the impact of socioeconomic factors on child health.
Abstract

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