Awakening cortisol and subclinical cardiovascular disease markers in police officers: the Buffalo cardio-metabolic occupational police stress (BCOPS) pilot study.
Violanti-JM; Burchfiel-CM; Andrew-ME; Dorn-J; Fekedulegn-D; Hartley-T; Charles-LE; Miller-DB
Am J Epidemiol 2006 Jun; 163(11)(Suppl):S210
Police officers have an increased risk of job stress and cardiovascular disease. In the BCOPS pilot study awakening salivary cortisol levels were determined in 75 Buffalo, NY police officers (42 men and 33 women) to assess the association between a biomarker of stress and subclinical cardiovascular disease (brachial artery flow mediated dilation (FMD)). Saliva was collected immediately upon awakening and at three 15-minute intervals. A competitive chemiluminescence immunoassay determined cortisol level; results were expressed as area under the curve (AUC) above baseline and classified into gender-specific low, medium and high tertiles. Ultrasound measures of FMD were expressed as % change from baseline to maximal dilation. Analysis of covariance was used to estimate unadjusted and adjusted mean % change in brachial artery dilation across cortisol tertiles, stratified by gender. Adjustment for lifestyle factors resulted in a significant inverse trend (linear p = 0.017) in % brachial dilation across cortisol tertile levels in women, with the highest tertile having the lowest % brachial dilation (high = 1.7% vs. medium = 6.2% vs. low 5.9% dilation). No significant trend across cortisol tertiles was found in men (p = 0.79). Results suggest that female police officers with hypersecretion of cortisol after awakening may be more likely to experience impaired endothelial function. Potential reasons for gender differences include types and severity of job and personal stress exposure.
Cardiovascular-system; Cardiovascular-system-disease; Cardiovascular-disease; Diseases; Occupational-diseases; Police-officers; Job-stress; Risk-factors; Risk-analysis; Biomarkers; Demographic-characteristics; Sex-factors; Occupational-exposure
American Journal of Epidemiology