Effects of urinary cortisol levels and resting heart rate on the risk for fatal and nonfatal cardiovascular events. (May 2016)

• Record Type: Journal Article
• Authors: van Ockenburg, Sonja L.; Rosmalen, Judith G.M.; Bakker, Stephan J.L.; de Jonge, Peter; Gans, Reinold O.B.
• Is Part Of: Atherosclerosis. Volume 248(2016)
• Page Start: 44
• Page End: 50
• Publication Date: 2016-05
• Subjects: 24-h urinary cortisol -- Resting heart rate -- Cardiovascular events -- Observational cohort study; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2016.02.030
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Higher cortisol levels are associated with cardiovascular mortality in the elderly. It is unclear whether this association also exists in a general population of younger adults and for non-fatal cardiovascular events. Likewise, resting heart rate is associated with cardiovascular mortality, but fewer studies have also considered non-fatal events. The goal of this study was to investigate whether twenty-four-hour urinary cortisol (24-h UFC) levels and resting heart rate (RHR) predict major adverse fatal and non-fatal cardiovascular events (MACE) in the general population. Methods: We used data from a subcohort of the PREVEND study, a prospective general population based cohort study with a follow-up of 6.4 years for 24-h UFC and 10.6 years for RHR. Participants were 3432 adults (mean age 49 years, range 28–75). 24-h UFC was collected and measured by liquid chromatography—tandem mass spectrometry. RHR was measured at baseline in a supine position for 10 min with the Dinamap XL Model 9300. Information about cardiovascular events and mortality was obtained from the Dutch national registry of hospital discharge diagnoses and the municipal register respectively. Results: 24-h UFC did not significantly increase the hazard of MACE (hazard ratio = 0.999, 95% confidence interval = 0.993–1.006, p = 0.814). RHR increased the risk for MACE with 17% per 10 extra heart beats per minute (hazard ratio = 1.016, 95% confidence interval = 1.001–1.031, p = 0.036) after adjustment for conventional risk factors. Conclusions: In contrast to 24-h UFC, RHR is a risk marker for MACE in the general population. Highlights: Cox proportional hazard models were used to predict major adverse cardiovascular events in the general population. Higher levels of 24 h urinary cortisol do not increase the risk of major fatal or nonfatal cardiovascular events. Resting heart rate increases the risk of major adverse fatal and nonfatal cardiovascular events with 17% per 10 beats/minute.