Abstract
Although clinical observations implicate cortisol in hypertension, the epidemiological evidence is less compelling. Little is known about the relationship between dehydroepiandrosterone sulphate (DHEAS) and hypertension, and nothing about the association with the cortisol:DHEAS ratio. The present analyses of data obtained from Vietnam-era US veterans examined the associations between cortisol, DHEAS, their ratio and hypertension. Participants were 4180 male veterans. From military files, telephone interviews and a medical examination, sociodemographic and health data were collected. At medical examination, a fasted morning blood sample was collected to assay serum cortisol and DHEAS, blood pressure measured and body mass index (BMI) determined. Hypertension was defined by having one of the following: a reported physician diagnosis, taking antihypertensive medication, an average systolic blood pressure ⩾140 mm Hg and an average diastolic blood pressure ⩾90 mm Hg. Cortisol and the cortisol:DHEAS ratio were positively associated with hypertension (P<0.001), whereas DHEAS was negatively associated; the latter relationship was attenuated to non-significance (P=0.06) in models that adjusted for age, sociodemographics, place of service, health behaviours and BMI. The present analyses provide confirmation of a positive association between cortisol and the cortisol:DHEAS ratio and population hypertension.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 digital issues and online access to articles
$119.00 per year
only $9.92 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Hammer F, Stewart PM . Cortisol metabolism in hypertension. Best Pract Res Clin Endocrinol Metab 2006; 20: 337–353.
Whitworth JA, Williamson PM, Mangos G, Kelly JJ . Cardiovascular consequences of cortisol excess. Vasc Health Risk Manag 2005; 1: 291–299.
Whitworth JA, Williamson PM, Brown MA, Morris MJ . Neuropeptide Y in cortisol-induced hypertension in male volunteers. Clin Exp Pharmacol Physiol 1994; 21: 435–438.
Whitworth JA, Williamson PM, Brown MA, Colman P . Hyperinsulinemia is not a cause of cortisol-induced hypertension. Am J Hypertens 1994; 7: 562–565.
Connell JM, Whitworth JA, Davies DL, Lever AF, Richards AM, Fraser R . Effects of ACTH and cortisol administration on blood pressure, electrolyte metabolism, atrial natriuretic peptide and renal function in normal man. J Hypertens 1987; 5: 425–433.
Whitworth JA, Saines D, Scoggins BA . Blood pressure and metabolic effects of cortisol and deoxycorticosterone in man. Clin Exp Hypertens A 1984; 6: 795–809.
Filipovsky J, Ducimetiere P, Eschwege E, Richard JL, Rosselin G, Claude JR . The relationship of blood pressure with glucose, insulin, heart rate, free fatty acids and plasma cortisol levels according to degree of obesity in middle-aged men. J Hypertens 1996; 14: 229–235.
Phillips DI, Barker DJ, Fall CH, Seckl JR, Whorwood CB, Wood PJ et al. Elevated plasma cortisol concentrations: a link between low birth weight and the insulin resistance syndrome? J Clin Endo Metab 1998; 83: 757–760.
Walker BR, Soderberg S, Lindahl B, Olsson T . Independent effects of obesity and cortisol in predicting cardiovascular risk factors in men and women. J Intern Med 2000; 247: 198–204.
Ward AM, Fall CH, Stein CE, Kumaran K, Veena SR, Wood PJ et al. Cortisol and the metabolic syndrome in South Asians. Clin Endocrin 2003; 58: 500–505.
Fraser R, Ingram MC, Anderson NH, Morrison C, Davies E, Connell JM . Cortisol effects on body mass, blood pressure, and cholesterol in the general population. Hypertension 1999; 33: 1364–1368.
Sacco M, Valenti G, Corvi Mora P, Wu FC, Ray DW . DHEA, a selective glucocorticoid receptor antagonist: its role in immune system regulation and metabolism. J Endocrinol Invest 2002; 25: 81–82.
Butcher SK, Killampalli V, Lascelles D, Wang K, Alpar EK, Lord JM . Raised cortisol:DHEAS ratios in the elderly after injury: potential impact upon neutrophil function and immunity. Aging Cell 2005; 4: 319–324.
Arlt W, Hammer F, Sanning P, Butcher SK, Lord JM, Allolio B et al. Dissociation of serum dehydroepiandrosterone and dehydroepiandrosterone sulfate in septic shock. J Clin Endocrin Metab 2006; 91: 2548–2554.
Dimopoulou I, Stamoulis K, Ilias I, Tzanela M, Lyberopoulos P, Orfanos S et al. A prospective study on adrenal cortex responses and outcome prediction in acute critical illness: results from a large cohort of 203 mixed ICU patients. Intensive Care Med 2007; 33: 2116–2121.
Wade CE, Lindberg JS, Cockrell JL, Lamiell JM, Hunt MM, Ducey J et al. Upon-admission adrenal steroidogenesis is adapted to the degree of illness in intensive care unit patients. J Clin Endocrin Metab 1988; 67: 223–227.
Schunkert H, Hense HW, Andus T, Riegger GA, Straub RH . Relation between dehydroepiandrosterone sulfate and blood pressure levels in a population-based sample. Am J Hypertens 1999; 12: 1140–1143.
Maccario M, Mazza E, Ramunni J, Oleandri SE, Savio P, Grottoli S et al. Relationships between dehydroepiandrosterone-sulphate and anthropometric, metabolic and hormonal variables in a large cohort of obese women. Clin Endocrinol 1999; 50: 595–600.
Haffner SM, Newcomb PA, Marcus PM, Klein BE, Klein R . Relation of sex hormones and dehydroepiandrosterone sulfate (DHEA-SO4) to cardiovascular risk factors in postmenopausal women. Am J Epidemiol 1995; 142: 925–934.
Boscarino JA . Psychobiologic predictors of disease mortality after psychological trauma: implications for research and clinical surveillance. J Nervous Mental Dis 2008; 196: 100–107.
The Centers for Disease Control Vietnam Experience Study. Health status of Vietnam veterans. I. Psychosocial characteristics. JAMA 1988; 259: 2701–2707.
The Centers for Disease Control Vietnam Experience Study. Health status of Vietnam veterans. II. Physical Health. JAMA 1988; 259: 2708–2714.
The Centers for Disease Control Vietnam Experience Study. Health Status of Vietnam Veterans. III: Medical Examinations. Atlanta: Centers for Disease Control, 1989.
Phillips AC, Batty GD, Gale CR, Deary IJ, Osborn D, MacIntyre K et al. Generalised anxiety disorder, major depressive disorder, and their comorbidity as predictors of all-cause and cardiovascular mortality: the Vietnam Experience Study. Psychosom Med 2009; 71: 395–403.
Patten SB, Williams JV, Lavorato DH, Campbell NR, Eliasziw M, Campbell TS . Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study. Psychosom Med 2009; 71: 273–279.
Carroll D, Phillips AC, Gale CR, Batty GD . Generalised anxiety disorder and major depressive disorder, their comorbidity and hypertension in middle-aged men. Psychosom Med 2010; 72: 16–19.
Phillips AC, Carroll D, Gale CR, Lord JM, Arlt W, Batty GD . Cortisol and the cortisol:DHEAS ratio in the vietnam experience study veterans with major depressive disorder, generalised anxiety disorder, and their comorbidity. Psychoneuroendocrinology 2010 (in press).
Matuszek MA, Boutcher SH . Elevated levels of circulating cortisol in young normotensive adult men with a family history of hypertension. Clin Exp Pharmacol Physiol 2008; 35: 280–286.
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.
Phillips DI . Fetal programming of the neuroendocrine response to stress: links between low birth weight and the metabolic syndrome. Endocr Res 2004; 30: 819–826.
Barker DJ, Osmond C, Golding J, Kuh D, Wadsworth ME . Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ 1989; 298: 564–567.
Seckl JR, Meaney MJ . Glucocorticoid programming. Ann NY Acad Sci 2004; 1032: 63–84.
Friso S, Pizzolo F, Choi SW, Guarini P, Ravagnani V, Carletto A et al. Epigenetic control of 11 beta-hydroxysteroid dehydrogenase 2 gene promoter is related to human hypertension. Atherosclerosis 2008; 199: 323–327.
Orentreich N, Brind JL, Rizer RL, Vogelman JH . Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood. J Clin Endocrin Metab 1984; 59: 551–555.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Carroll, D., Phillips, A., Lord, J. et al. Cortisol, dehydroepiandrosterone sulphate, their ratio and hypertension: evidence of associations in male veterans from the Vietnam Experience Study. J Hum Hypertens 25, 418–424 (2011). https://doi.org/10.1038/jhh.2011.6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jhh.2011.6
Keywords
This article is cited by
-
Dehydroepiandrosterone: a potential therapeutic agent in the treatment and rehabilitation of the traumatically injured patient
Burns & Trauma (2019)
-
The Effect of an Intervention Teaching Adolescents that People can Change on Depressive Symptoms, Cognitive Schemas, and Hypothalamic-Pituitary-Adrenal Axis Hormones
Journal of Abnormal Child Psychology (2019)
-
Is DHAS related to hypertension? Perhaps, but it is still impossible to be certain
Journal of Human Hypertension (2011)