Serum Cortisol as a Predictive Biomarker of Cardiovascular Stress Reactivity and Hypertension Risk in Genetically Predisposed Individuals

Background: Increased cortisol stress reactivity may lead to cardiovascular disease and hypertension due to the consequences of frequent exposure to excessive circulating cortisol concentration. Cortisol affects areas of the brain that are involved in the control of BP, such as the hypothalamus and limbic system. Cardiovascular stress reactivity refers to the enormousness of change in heart rate and blood pressure during an aversive, challenging, or engaging laboratory stressor. Cardiovascular reactivity to stress has been revealed to be a predictor of future cardiovascular risk. During stress responses, the hypothalamic-pituitary-adrenocortical (HPA) axis is activated, further leads to increased secretion of hormones such as adrenocorticotropic hormone (ACTH) and then glucocorticoid hormones like cortisol. Aim: To evaluate the role of serum cortisol as a biomarker for early detection of cardiovascular stress reactivity and prediction of hypertension in genetically predisposed individuals. Methods: A total of 70 Cases (18-30 years old offspring of hypertensive parents) and 70 Controls (18-30 years old offspring of normotensive parents) were included in the study. Morning Serum Cortisol, Blood pressure (BP) and Anthropometric variables were obtained for all participants. Results: In the present study we found that the Serum cortisol levels were significantly higher in the case group compared to controls (p < 0.05). Higher cortisol levels were associated with greater cardiovascular stress reactivity in at risk individuals. Conclusion: We observed the significantly elevated level of serum cortisol which may serve as an early biomarker of cardiovascular stress reactivity and potential predictor of hypertension in genetically predisposed individuals. Delineating these mechanisms could provide insights into endothelial activation, inflammation, and the pathogenesis of hypertension.