Background: Streß is considered amodifiable risk factor for cardiovascular disease. Scalp hair analysis is a tool to aßeß long-term exposure to the streß hormone cortisol. We aimed to determine the aßociation between hair cortisol concentrations (HCC) and clinical characteristics in patients with structural heart disease. Additionally, we investigated potential predictors for longitudinal change in HCC. Methods: The study consisted of 261 patients with structural heart disease from a randomized controlled trial of mindfulneß training. One sample of scalp hair was used to determine HCC both at baseline and at 12-week follow-up. In 151 patients, HCC was available (mean age: 41.3 years, range 18-65). We investigated the aßociation between HCC at baseline and several physiological measures (BMI, blood preßure, heart rate, respiratory rate, 6-minute walk test), as well as psychological parameters (physical and mental component summary measures (SF-36), emotional distreß (HADS), and perceived streß). Additionally, we used these clinical parameters to predict HCC change over time. Results: The median HCC was 22.3 pg/mg of hair (23.5 interquartile range). In multivariable linear regreßion analyses, an aßociation was observed between log-transformed HCC and BMI (β 0.171, p =0.037), respiratory rate (β 0.194, p=0.016), and the physical summary score (β-0.163, p=0.054). Independent predictors of log transformed HCC change after 12weekswere mental summary score (β-0.200, p=0.019) and diastolic blood preßure (β -0.171, p = 0.049). Conclusions: In patients with structural heart disease a positive aßociation exists between HCC and BMI. Mental health status may predict a change in long-term cortisol over time.

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International Journal of Cardiology
Department of Internal Medicine

Younge, J., Wester, V., van Rossum, L., Gotink, R., Wery, M. F., Utens, E., … Roos-Hesselink, J. (2015). Cortisol levels in scalp hair of patients with structural heart disease. International Journal of Cardiology, 184(1), 71–78. doi:10.1016/j.ijcard.2015.02.005