PHYSIOLOGICAL ADAPTATIONS TO CHRONIC STRESS: A CLINICAL AND BIOCHEMICAL EVALUATION OF CORTISOL REGULATION AND CARDIOVASCULAR HEALTH IN ADULTS
Main Article Content
Keywords
Chronic stress, cortisol, heart-rate variability, arterial stiffness, cardiometabolic risk.
Abstract
Largely, chronic psychological stress is being established as a biological mediator of cardiometabolic risk. The problems with hypothalamic-pituitary-adrenal axis dysregulation and autonomic disregulation can be observed in the form of the varying cortisol patterns and unfavorable cardiovascular phenotypes. The current paper compared the endocrine and cardiovascular adaptation to chronic stress in adulthood. This was a cross-sectional analytical study that was carried out in a tertiary research establishment. Those adults aged 25-60 years who had experienced persistent stress [?]6 months were recruited after screening and exclusions. Stress burden was measured by using standardized questionnaires. Sera and salivary samples were taken fast to measure cortisol (diurnal profile) and biochemical (C-reactive protein, lipids) samples. Cardiovascular measures were blood pressure, resting heart rate, heart-rate variability (time- and frequency-domain measures) and carotid-femoral pulse wave velocity. Multivariate regression was used to test the relationship between stress indices, cortisol patterns, and cardiovascular consequences controlling by age, sex, Body Mass Index (BMI), and lifestyle variables. Two hundred and ten subjects (mean age 41.7 +- 9.3 years; 54.3% female) were studied. There was a flattened diurnal slope of cortisol with high evening levels. The adjusted models showed a positive correlation between serum and evening salivary cortisol and systolic blood pressure, and the lower the vagal indices the stronger the positive association between pulse pressure and vagal indices. There were also signs of mild inflammatory and lipid disturbances on biochemical markers and they are a result of developing cardiometabolic demand. Adults also had chronic stress that was linked to the dysregulation of Hypothalamic-Pituitary-Adrenal (HPA)-axis, and cardiovascular profiles were unfavorable. An early detection and specific prevention of cardiometabolic risk associated with stress might be achieved by incorporating the measures of diurnal cortisol, Heart Rate Variability (HRV), and vascular stiffness into the regular routine assessment.
References
2. Jones A, Pruessner JC, McMillan MR, Jones RW, Kowalik GT, Steeden JA, Williams B, Taylor AM, Muthurangu V. Physiological adaptations to chronic stress in healthy humans–why might the sexes have evolved different energy utilisation strategies?. The Journal of physiology. 2016 Aug 1;594(15):4297-307.
3. Iob E, Steptoe A. Cardiovascular disease and hair cortisol: a novel biomarker of chronic stress. Current cardiology reports. 2019 Oct;21(10):116.
4. James KA, Stromin JI, Steenkamp N, Combrinck MI. Understanding the relationships between physiological and psychosocial stress, cortisol and cognition. Frontiers in endocrinology. 2023 Mar 6;14:1085950.
5. KUMAR A, GORU B, KHAN MS, PATHAPATI R. STUDY OF PHYSIOLOGICAL AND BIOCHEMICAL VARIATIONS IN POPULATION GROUPS UNDERGOING ACUTE OR CHRONIC STRESS. Asian J Pharm Clin Res. 2024;17(5):56-60.
6. Vaccarino V, Bremner JD. Stress and cardiovascular disease: an update. Nature Reviews Cardiology. 2024 Sep;21(9):603-16.
7. Munir LZ, du Toit EF. Impact of chronic psychological stress on cardiovascular disease risk: A narrative review. Heart and Mind. 2024 Oct 1;8(4):268-78.
8. Knezevic E, Nenic K, Milanovic V, Knezevic NN. The role of cortisol in chronic stress, neurodegenerative diseases, and psychological disorders. Cells. 2023 Nov 29;12(23):2726.
9. Sandrini L, Ieraci A, Amadio P, Zarà M, Barbieri SS. Impact of acute and chronic stress on thrombosis in healthy individuals and cardiovascular disease patients. International journal of molecular sciences. 2020 Oct 22;21(21):7818.
10. Cozma S, Dima-Cozma LC, Ghiciuc CM, Pasquali V, Saponaro A, Patacchioli FR. Salivary cortisol and α-amylase: subclinical indicators of stress as cardiometabolic risk. Brazilian journal of medical and biological research. 2017;50(2):e5577.
11. Urizar Jr GG, Miller K, Saldaña KS, Garovoy N, Sweet CM, King AC. Effects of health behavior interventions on psychosocial outcomes and cortisol regulation among chronically stressed midlife and older adults. International Journal of Behavioral Medicine. 2021 Oct;28(5):627-40.
12. Kokka I, Chrousos GP, Darviri C, Bacopoulou F. Measuring adolescent chronic stress: a review of established biomarkers and psychometric instruments. Hormone research in paediatrics. 2023 Mar 20;96(1):74-82.
13. Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Annals of the new York Academy of Sciences. 2017 Mar;1391(1):20-34.
14. Franklin BA, Rusia A, Haskin-Popp C, Tawney A. Chronic stress, exercise and cardiovascular disease: placing the benefits and risks of physical activity into perspective. International journal of environmental research and public health. 2021 Sep 21;18(18):9922.
15. O'Connor DB, Thayer JF, Vedhara K. Stress and health: A review of psychobiological processes. Annual review of psychology. 2021 Jan 4;72(1):663-88.
16. Berens AE, Jensen SK, Nelson III CA. Biological embedding of childhood adversity: from physiological mechanisms to clinical implications. BMC medicine. 2017 Jul 20;15(1):135.
17. Andreadi A, Andreadi S, Todaro F, Ippoliti L, Bellia A, Magrini A, Chrousos GP, Lauro D. Modified Cortisol Circadian Rhythm: The Hidden Toll of Night-Shift Work. International Journal of Molecular Sciences. 2025 Feb 27;26(5):2090.
18. Kivimäki M, Bartolomucci A, Kawachi I. The multiple roles of life stress in metabolic disorders. Nature Reviews Endocrinology. 2023 Jan;19(1):10-27.
19. Waagbø R, Jørgensen SM, Timmerhaus G, Breck O, Olsvik PA. Short-term starvation at low temperature prior to harvest does not impact the health and acute stress response of adult Atlantic salmon. PeerJ. 2017 Apr 27;5:e3273.
20. Liu CH, Doan SN. Innovations in biological assessments of chronic stress through hair and nail cortisol: Conceptual, developmental, and methodological issues. Developmental psychobiology. 2019 Apr;61(3):465-76.
21. Engert V, Blasberg JU, Köhne S, Strauss B, Rosendahl J. Resilience and personality as predictors of the biological stress load during the first wave of the Covid-19 pandemic in Germany. Translational Psychiatry. 2021 Aug 28;11(1):443.
22. Wegner M, Koutsandréou F, Müller-Alcazar A, Lautenbach F, Budde H. Effects of different types of exercise training on the cortisol awakening response in children. Frontiers in endocrinology. 2019 Jul 26;10:463.
23. George MY, Abdel Mageed SS, Mansour DE, Fawzi SF. The cortisol axis and psychiatric disorders: an updated review. Pharmacological Reports. 2025 Sep 16:1-27.
24. Shchaslyvyi AY, Antonenko SV, Telegeev GD. Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. International Journal of Environmental Research and Public Health. 2024 Aug 16;21(8):1077.
25. Duseja S, Parikh HA, Duseja S. Evaluating the clinico-biochemical association between stress and chronic periodontitis by estimation of serum cortisol and serum chromogranin a levels. Advances in Human Biology. 2025 Jan 1;15(1):73-80.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Rajanish chaurasiya
Physiology, Himalaya Medical college and Hospital, chiksi, Paliganj, patna - 801110
Kazi Kamranuddin Fazaluddin
Intern, Indian institute of medical science and research (IIMSR),
Shashwat Pandey
Institute of Pharmaceutical Sciences , University of Lucknow, 226031, Uttar Pradesh, India,
Dr. Rohan Chauhan
Junior Resident, Critical care, Christian Medical College and Hospital, Brown Road , Ludhiana, Punjab, India,
Dr Gaurav Uppal
Consultant Psychiatrist, Department: Psychiatry College or university name: Satyam Hospital, Arti Chowk. City: Ludhiana.
Dr Ashwin M Sathe
Orthopedic Surgeon, Ryazan State I P Pavlov Medical University,
