Increased Hair Cortisol Levels Is Associated With Coronary Artery Calcification in Middle-Aged Women but Not in Men

BACKGROUND: Chronic stress exposure has been linked to cardiovascular risk factors and cardiovascular diseases, but not to coronary artery calcification (CAC). Hair cortisol concentrations is a potential biomarker of chronic stress. Atherosclerosis is the predominant cardiovascular disease and the leading cause of death in developed countries. Coronary artery calcification is a sign of atherosclerosis in the coronary arteries and predicts coronary heart disease. Most men and women are to some degree affected by coronary artery calcification at the age of 65. OBJECTIVES: To analyse if increased hair cortisol levels are associated with CAC in a middle-aged population with special focus on women. Further, to analyse the relative importance of HCC for CACs in relation to established cardiovascular risk factors. METHODS: Hair samples, cardiac computed tomography data, health questionnaires, and anthropometric measures were collected in 4821 men and women aged 50-65 years, from the Swedish Cardio Pulmonary bioImage Study. A competitive radioimmunoassay was used to analyze cortisol levels in extracts of hair. Correlation, descriptive, regression and path analyses were applied. RESULTS: A significant association between high HCC and high CAC score was found among women (p=0.007), but not among men. HCC was significantly directly associated with a higher CAC score among women, as were the other classical cardiovascular risk factors. CONCLUSION: The amount of calcified plaque (CAC score) in the coronary arteries of women was significantly associated with higher cortisol levels in hair, while this association was not observed in men.