Psychoneuroendocrinology
Volume 32, Issue 5 , Pages 430-436 , June 2007

Evidence for altered hypothalamus–pituitary–adrenal axis functioning in systemic hypertension: Blunted cortisol response to awakening and lower negative feedback sensitivity

  • Petra H. Wirtz

      Affiliations

    • Department of Clinical Psychology and Psychotherapy, Psychological Institute, University of Zurich, Binzmuhlestrasse 14/Box 26, CH-8050 Zurich, Switzerland
    • Corresponding Author InformationCorresponding author. Tel.: +41446357367; fax: +41446357359.
  • ,
  • Roland von Känel

      Affiliations

    • Department of General Internal Medicine, University Hospital Berne, Switzerland
  • ,
  • Luljeta Emini

      Affiliations

    • Department of Clinical Psychology and Psychotherapy, Psychological Institute, University of Zurich, Binzmuhlestrasse 14/Box 26, CH-8050 Zurich, Switzerland
  • ,
  • Katharina Ruedisueli

      Affiliations

    • Department of Clinical Psychology and Psychotherapy, Psychological Institute, University of Zurich, Binzmuhlestrasse 14/Box 26, CH-8050 Zurich, Switzerland
  • ,
  • Sara Groessbauer

      Affiliations

    • Department of Clinical Psychology and Psychotherapy, Psychological Institute, University of Zurich, Binzmuhlestrasse 14/Box 26, CH-8050 Zurich, Switzerland
  • ,
  • Andreas Maercker

      Affiliations

    • Department of Psychopatholgy, Psychological Institute, University of Zurich, Switzerland
  • ,
  • Ulrike Ehlert

      Affiliations

    • Department of Clinical Psychology and Psychotherapy, Psychological Institute, University of Zurich, Binzmuhlestrasse 14/Box 26, CH-8050 Zurich, Switzerland

Received 14 November 2006 ,Revised 29 January 2007 ,Accepted 18 February 2007.

References 

  1. al’Absi M, Arnett DK. Adrenocortical responses to psychological stress and risk for hypertension. Biomed. Pharmacother. 2000;54:234–244
  2. Babyak MA. What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psychosom. Med. 2004;66:411–421
  3. Buchner A, Faul F, Erdfelder E. G-Power: A Priori, Post Hoc, and Compromise Power Analyses. Version 2.0. Trier, Germany: University of Trier; 1997;
  4. Clow A, Thorn L, Evans P, Hucklebridge F. The awakening cortisol response: methodological issues and significance. Stress. 2004;7:29–37
  5. Ebrecht M, Buske-Kirschbaum A, Hellhammer D, Kern S, Rohleder N, Walker B, et al. Tissue specificity of glucocorticoid sensitivity in healthy adults. J. Clin. Endocrinol. Metab. 2000;85:3733–3739
  6. Eller NH, Netterstrom B, Hansen AM. Cortisol in urine and saliva: relations to the intima media thickness, IMT. Atherosclerosis. 2001;159:175–185
  7. Esposito F, Dusick JR, Cohan P, Moftakhar P, McArthur D, Wang C, et al. Clinical review: early morning cortisol levels as a predictor of remission after transsphenoidal surgery for Cushing's disease. J. Clin. Endocrinol. Metab. 2006;91:7–13
  8. Hautzinger M, Bailer M. Allgemeine Depressionsskala. Weinheim: Beltz Test GmbH; 1993;
  9. Hellhammer J, Fries E, Schweisthal OW, Schlotz W, Stone AA, Hagemann D. Several daily measurements are necessary to reliably assess the cortisol rise after awakening: state- and trait components. Psychoneuroendocrinology. 2007;32:80–86
  10. Kaplan NM. Importance of coronary heart disease risk factors in the management of hypertension. An overview. Am. J. Med. 1989;86:1–4
  11. Kenyon CJ, Fraser R. Biochemistry of Steroid Hypertension. New York: Raven Press; 1992;
  12. Kjeldsen SE, Erdine S, Farsang C, Sleight P, Mancia G. 1999 WHO/ISH hypertension guidelines—highlights & ESH update. J. Hypertens. 2002;20:153–155
  13. Kornel L, Starnes WR, Hill A. Studies on steroid conjugates. VI. Quantitative paper chromatography of urinary corticosteroids in essential hypertension. J. Clin. Endocrinol. Metab. 1969;29:1608–1617
  14. Ku YH. Role of limbic peptidergic circuits in regulation of arterial pressure, relevant to development of essential hypertension. Neuropeptides. 2006;40:299–308
  15. Litchfield WR, Hunt SC, Jeunemaitre X, Fisher ND, Hopkins PN, Williams RR, et al. Increased urinary free cortisol: a potential intermediate phenotype of essential hypertension. Hypertension. 1998;31:569–574
  16. Mulatero P, Panarelli M, Schiavone D, Rossi A, Mengozzi G, Kenyon CJ, et al. Impaired cortisol binding to glucocorticoid receptors in hypertensive patients. Hypertension. 1997;30:1274–1278
  17. Pfohl B, Rederer M, Coryell W, Stangl D. Association between post-dexamethasone cortisol level and blood pressure in depressed inpatients. J. Nerv. Ment. Dis. 1991;179:44–47
  18. Pruessner JC, Wolf OT, Hellhammer DH, Buske-Kirschbaum A, von Auer K, Jobst S, et al. Free cortisol levels after awakening: a reliable biological marker for the assessment of adrenocortical activity. Life Sci. 1997;61:2539–2549
  19. Pruessner JC, Kirschbaum C, Meinlschmid G, Hellhammer DH. Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology. 2003;28:916–931
  20. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. App. Psychol. Meas. 1977;3:385–401
  21. Rosmond R, Bjorntorp P. The hypothalamic–pituitary–adrenal axis activity as a predictor of cardiovascular disease, type 2 diabetes and stroke. J. Intern. Med. 2000;247:188–197
  22. Ross R. Atherosclerosis—an inflammatory disease. N. Engl. J. Med. 1999;340:115–126
  23. Sapolsky RM, Romero LM, Munck AU. How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions. Endocr. Rev. 2000;21:55–89
  24. Schulz P, Schlotz W, Becker P. Trierer Inventar Zum Chronischen Stress. Göttingen: Hogrefe; 2004;
  25. Soro A, Ingram MC, Tonolo G, Glorioso N, Fraser R. Evidence of coexisting changes in 11 beta-hydroxysteroid dehydrogenase and 5 beta-reductase activity in subjects with untreated essential hypertension. Hypertension. 1995;25:67–70
  26. Steptoe A, Kunz-Ebrecht SR, Brydon L, Wardle J. Central adiposity and cortisol responses to waking in middle-aged men and women. Int. J. Obes. Relat. Metab. Disord. 2004;28:1168–1173
  27. Stevens A, Ray DW, Zeggini E, John S, Richards HL, Griffiths CE, et al. Glucocorticoid sensitivity is determined by a specific glucocorticoid receptor haplotype. J. Clin. Endocrinol. Metab. 2004;89:892–897
  28. von Kanel R, Kudielka BM, Abd-el-Razik A, Gander ML, Frey K, Fischer JE. Relationship between overnight neuroendocrine activity and morning haemostasis in working men. Clin. Sci. (Lond.). 2004;107:89–95
  29. Walker BR. Abnormal glucocorticoid activity in subjects with risk factors for cardiovascular disease. Endocr. Res. 1996;22:701–708
  30. Walker BR, Best R, Shackleton CH, Padfield PL, Edwards CR. Increased vasoconstrictor sensitivity to glucocorticoids in essential hypertension. Hypertension. 1996;27:190–196
  31. Walker BR, Phillips DI, Noon JP, Panarelli M, Andrew R, Edwards HV, et al. Increased glucocorticoid activity in men with cardiovascular risk factors. Hypertension. 1998;31:891–895
  32. Watt GC, Harrap SB, Foy CJ, Holton DW, Edwards HV, Davidson HR, et al. Abnormalities of glucocorticoid metabolism and the renin-angiotensin system: a four-corners approach to the identification of genetic determinants of blood pressure. J. Hypertens. 1992;10:473–482
  33. Wessa M, Rohleder N, Kirschbaum C, Flor H. Altered cortisol awakening response in posttraumatic stress disorder. Psychoneuroendocrinology. 2006;31:209–215
  34. Whitworth JA, Gordon D, McLachlan-Troup N, Scoggins BA, Moulds RW. Dexamethasone suppression in essential hypertension: effects on cortisol and blood pressure. Clin. Exp. Hypertens. A. 1989;11:323–335
  35. Whitworth JA, Mangos GJ, Kelly JJ. Cushing, cortisol, and cardiovascular disease. Hypertension. 2000;36:912–916
  36. Williams E, Magid K, Steptoe A. The impact of time of waking and concurrent subjective stress on the cortisol response to awakening. Psychoneuroendocrinology. 2005;30:139–148
  37. Wirtz PH, Von Kanel R, Frey K, Ehlert U, Fischer JE. Glucocorticoid sensitivity of circulating monocytes in essential hypertension. Am. J. Hypertens. 2004;17:489–494
  38. Wirtz PH, Ehlert U, Emini L, Rudisuli K, Groessbauer S, Mausbach BT, et al. The role of stress hormones in the relationship between resting blood pressure and coagulation activity. J. Hypertens. 2006;24:2409–2416
  39. Wirtz PH, von Kanel R, Mohiyeddini C, Emini L, Ruedisueli K, Groessbauer S, et al. Low social support and poor emotional regulation are associated with increased stress hormone reactivity to mental stress in systemic hypertension. J. Clin. Endocrinol. Metab. 2006;91:3857–3865
  40. Wust S, Wolf J, Hellhammer DH, Federenko I, Schommer N, Kirschbaum C. The cortisol awakening response—normal values and confounds. Noise Health. 2000;2:79–88

PII: S0306-4530(07)00038-8

doi: 10.1016/j.psyneuen.2007.02.006

Psychoneuroendocrinology
Volume 32, Issue 5 , Pages 430-436 , June 2007