Disclosures: The authors report no relevant financial disclosures.
September 13, 2021
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Elevated stress hormones confer increased risk for hypertension

Disclosures: The authors report no relevant financial disclosures.
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Elevated levels of stress hormones such as norepinephrine, epinephrine, dopamine and cortisol were associated with increased risk for hypertension, and high levels of cortisol was also linked to CV events, researchers reported.

Kosuke Inoue, MD, PhD, assistant professor of social epidemiology at Kyoto University, Japan, and epidemiologist at the Fielding School of Public Health at the University of California, Los Angeles, and colleagues prospectively analyzed 412 adults (mean age, 61 years; 50% women) without baseline hypertension from the MESA cohort study.

blood pressure being measured
Source: Adobe Stock

The stress hormones norepinephrine, epinephrine, dopamine and cortisol can increase with stress from life events, work, relationships, finances and more. And we confirmed that stress is a key factor contributing to the risk of hypertension and cardiovascular events,” Inoue said in a press release.

All participants had measurements of urinary norepinephrine, epinephrine, dopamine and cortisol. Median follow-up was 6.5 years for hypertension and 11.5 years for CV events.

During the study period, incident hypertension risk increased 31% for every doubling of norepinephrine (HR = 1.31; 95% CI, 1.06-1.31), 21% for every doubling of epinephrine (HR = 1.21; 95% CI, 1.03-1.41), 28% for every doubling of dopamine (HR = 1.28; 95% CI, 1-1.64) and 23% for every doubling of cortisol (HR = 1.23; 95% CI, 1.04-1.44), Inoue and colleagues found.

The associations were more prominent in participants younger than 60 years than in those aged 60 years or older, with a significant interaction by age for dopamine and cortisol (P for interaction for both = .04), according to the researchers.

Risk for incident CV events increased by 90% for every doubling of cortisol (HR = 1.9; 95% CI, 1.16-3.09), but was not affected by levels of the other three hormones, Inoue and colleagues wrote.

“The next key research question is whether and in which populations increased testing of stress hormones could be helpful,” Inoue said in the release. “Currently, these hormones are measured only when hypertension with an underlying cause or other related diseases are suspected. However, if additional screening could help prevent hypertension and cardiovascular events, we may want to measure these hormone levels more frequently.”