Subclinical Markers of Cardiovascular Disease Among Police Officers: A Longitudinal Assessment of the Cortisol Awakening Response and Flow Mediated Artery Dilation.

Violanti, John M; Fekedulegn, Desta; Andrew, Michael E; Charles, Luenda E; Gu, Ja K; Miller, Diane B · J Occup Environ Med · 2018

prospective_cohort · Level II

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Abstract

To examine the association of the cortisol awakening response (CAR) with change in brachial artery flow-mediated dilation (FMD%) in police officers over a 7-year period. Baseline CAR was obtained from four saliva samples taken 15 minutes apart immediately after awakening. Analysis of covariance was used to compare the change in FMD% (FMD%Follow-up-FMD%Baseline) across tertiles of area under the cortisol curve with respect to increase (AUCI). Regression analysis was use to assess trend. Officers (n = 172; 81% men) had a mean ± SD age of 41 ± 7.6 years. Men in the lowest AUCI tertile (ie, atypical waking cortisol pattern) had a significantly larger 7-year mean decline in FMD% (mean ± SE: -2.56 ± 0.64) compared with men in the highest tertile (-0.89 ± 0.69) (P = 0.0087). An awakening cortisol AUCI predicted worsening of FMD% approximately 7 years later among male officers.

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