High Cortisol Levels Directly Increase Heart Disease Risk, Study Shows
A genetic study finds that elevated cortisol—the body's stress hormone—directly causes higher blood pressure and hypertension, settling a long-standing medical question. The finding could reshape how doctors screen for and manage cardiovascular disease, and may influence workplace wellness programs and stress-reduction policies.
Originaltitel: Genetically predicted plasma cortisol and common chronic diseases: A Mendelian randomization study.
<p><strong>OBJECTIVE:</strong> Cushing's syndrome is characterized by hypercortisolaemia and is frequently accompanied by comorbidities such as type 2 diabetes, hypertension, osteoporosis, depression and schizophrenia. It is unclear whether moderate but lifelong hypercortisolaemia is causally associated with these diseases in the general population. We aimed to address this research gap using a Mendelian randomization approach.</p><p><strong>METHODS:</strong> We used three cortisol-associated genetic variants in the SERPINA6/SERPINA1 region as genetic instruments in a two-sample, inverse-variance-weighted Mendelian randomization analysis. We obtained summary-level statistics for cortisol and disease outcomes from publicly available genetic consortia, and meta-analysed them as appropriate. We conducted a multivariable Mendelian randomization analysis to assess potential mediating effects.</p><p><strong>RESULTS:</strong> A 1 standard deviation higher genetically predicted plasma cortisol was associated with greater odds of hypertension (odds ratio: 1.12; 95% confidence interval [CI]: 1.05-1.18) as well as higher systolic blood pressure (mean difference [MD]: 0.03 SD change; 95% CI: 0.01-0.05) and diastolic blood pressure (MD: 0.03 SD change; 95% CI: 0.01-0.04). There was no evidence of association with type 2 diabetes, osteoporosis, depression and schizophrenia. The association with hypertension was attenuated upon adjustment for waist circumference, suggesting potential mediation through central obesity.</p><p><strong>CONCLUSION:</strong> There is strong evidence for a causal association between plasma cortisol and greater risk for hypertension, potentially mediated by obesity.</p>