Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis
Research suggests that women experience greater cardiovascular ischemic effects from stress than men. Visceral adiposity is an endocrine tissue that differs by sex and interacts with stress hormones. We hypothesized that urinary cortisol would be associated with increased cardiovascular events and c...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | American Heart Journal Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602223000976 |
| _version_ | 1797450950013616128 |
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| author | Spencer Flynn Preethi Srikanthan Keeley Ravellette Kosuke Inoue Karol Watson Tamara Horwich |
| author_facet | Spencer Flynn Preethi Srikanthan Keeley Ravellette Kosuke Inoue Karol Watson Tamara Horwich |
| author_sort | Spencer Flynn |
| collection | DOAJ |
| description | Research suggests that women experience greater cardiovascular ischemic effects from stress than men. Visceral adiposity is an endocrine tissue that differs by sex and interacts with stress hormones. We hypothesized that urinary cortisol would be associated with increased cardiovascular events and change in coronary artery calcium score (CAC) in women, and these relationships would vary by central obesity. In the Multi-Ethnic Study of Atherosclerosis Stress Ancillary study, cortisol was quantified by 12-h overnight urine collection. Central obesity was estimated by waist-hip ratio (WHR). Multivariable Cox models estimated the relationship between cortisol and cardiovascular events and assessed for moderation by WHR. The relationship between cortisol and change in CAC Agatston score was assessed by Tobit regression models. 918 patients were analyzed with median follow up of 11 years. There was no association between urinary cortisol and cardiovascular events in the cohort. However, in individuals with below median WHR, higher urinary cortisol levels (upper tertile) were associated with higher cardiovascular event rates in the full cohort, women, and men, but not in groups with above median WHR. There was significant moderation by WHR in women, but not men, whereby the association between elevated cortisol and increased cardiovascular events diminished as WHR increased. Urinary cortisol was associated with increased change in CAC in women (P = 0.003) but not men, without moderation by WHR. Our study highlights associations between cortisol and subclinical atherosclerosis in women, and moderation of the relationship between cortisol and cardiovascular events by central obesity in both genders. |
| first_indexed | 2024-03-09T14:46:56Z |
| format | Article |
| id | doaj.art-f0db926cd9c74c0aa412f1340d585d3e |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-03-09T14:46:56Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-f0db926cd9c74c0aa412f1340d585d3e2023-11-27T04:15:15ZengElsevierAmerican Heart Journal Plus2666-60222023-12-0136100344Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosisSpencer Flynn0Preethi Srikanthan1Keeley Ravellette2Kosuke Inoue3Karol Watson4Tamara Horwich5David Geffen School of Medicine at UCLA, United States of AmericaUCLA Division of Endocrinology, United States of AmericaDavid Geffen School of Medicine at UCLA, United States of AmericaKyoto University Department of Social Epidemiology, JapanUCLA Division of Cardiology, United States of AmericaUCLA Division of Cardiology, United States of America; Corresponding author at: 10833 Le Conte Ave, CHS A2-237, Los Angeles, CA 90095, United States of America.Research suggests that women experience greater cardiovascular ischemic effects from stress than men. Visceral adiposity is an endocrine tissue that differs by sex and interacts with stress hormones. We hypothesized that urinary cortisol would be associated with increased cardiovascular events and change in coronary artery calcium score (CAC) in women, and these relationships would vary by central obesity. In the Multi-Ethnic Study of Atherosclerosis Stress Ancillary study, cortisol was quantified by 12-h overnight urine collection. Central obesity was estimated by waist-hip ratio (WHR). Multivariable Cox models estimated the relationship between cortisol and cardiovascular events and assessed for moderation by WHR. The relationship between cortisol and change in CAC Agatston score was assessed by Tobit regression models. 918 patients were analyzed with median follow up of 11 years. There was no association between urinary cortisol and cardiovascular events in the cohort. However, in individuals with below median WHR, higher urinary cortisol levels (upper tertile) were associated with higher cardiovascular event rates in the full cohort, women, and men, but not in groups with above median WHR. There was significant moderation by WHR in women, but not men, whereby the association between elevated cortisol and increased cardiovascular events diminished as WHR increased. Urinary cortisol was associated with increased change in CAC in women (P = 0.003) but not men, without moderation by WHR. Our study highlights associations between cortisol and subclinical atherosclerosis in women, and moderation of the relationship between cortisol and cardiovascular events by central obesity in both genders.http://www.sciencedirect.com/science/article/pii/S2666602223000976StressBody compositionCardiovascular eventsAtherosclerosis |
| spellingShingle | Spencer Flynn Preethi Srikanthan Keeley Ravellette Kosuke Inoue Karol Watson Tamara Horwich Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis American Heart Journal Plus Stress Body composition Cardiovascular events Atherosclerosis |
| title | Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis |
| title_full | Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis |
| title_fullStr | Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis |
| title_full_unstemmed | Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis |
| title_short | Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis |
| title_sort | urinary cortisol and cardiovascular events in women vs men the multi ethnic study of atherosclerosis |
| topic | Stress Body composition Cardiovascular events Atherosclerosis |
| url | http://www.sciencedirect.com/science/article/pii/S2666602223000976 |
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