Cortisol patterns and brachial artery reactivity in a high stress environment

School of Public Health and Health Professions, Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, NY 14214, USA.
Psychiatry Research (Impact Factor: 2.68). 09/2009; 169(1):75-81. DOI: 10.1016/j.psychres.2008.06.012
Source: PubMed

ABSTRACT Chronic stress can result in frequent or persistent challenges of the hypothalamic-pituitary-adrenal (HPA) axis resulting in abnormal cortisol patterns and increased risk for cardiovascular disease (CVD). Police work is an environment replete with stress. The present article describes associations between cortisol, a biomarker of stress, and brachial artery flow mediated dilation (FMD) in police officers. A random sample stratified on gender (n=100, 33% women) was generated from officers in a mid-sized urban department. Four salivary cortisol parameters were derived: after awakening, following a standardized high protein meal challenge, during the entire day, and after a dexamethasone suppression test. Continuous scan B-Mode ultrasound was used to measure percent change in brachial artery FMD following occlusion and release. Elevated cortisol secretion after awakening was significantly associated with impaired FMD in women, reflected by an inverse trend. Adjustment for age, smoking, and alcohol consumption did not appreciably alter this trend. A similar result was not evident among male officers. Responses of other cortisol challenges to the HPA axis were not associated with FMD. In conclusion, increased cortisol secretion after awakening was independently associated with impaired FMD in female police officers only, indicating a possible link between HPA axis stress response and subclinical CVD. However, because associations were not found with other cortisol parameters and were not evident in male officers, replication of these findings with a prospective study design may be warranted.

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Available from: Luenda E Charles, Aug 30, 2015
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    • "Furthermore, plasma cortisol levels are higher at rest and in response to acute mental stress in firefighters and police officers compared to controls (Tomei et al., 2003; Rosati et al., 2011; Robinson et al., 2013). These reported elevations in cortisol levels have been associated with impaired FMD in police offices (Violanti et al., 2009). These findings suggest that the challenges of the HPA axis experienced by high-stress occupations may lead to an increased risk of CVD. "
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    ABSTRACT: Psychological stress has been proposed as a major contributor to the progression of cardiovascular disease (CVD). Acute mental stress can activate the sympathetic-adrenal-medullary (SAM) axis, eliciting the release of catecholamines (NE and EPI) resulting in the elevation of heart rate (HR) and blood pressure (BP). Combined stress (psychological and physical) can exacerbate these cardiovascular responses, which may partially contribute to the elevated risk of CVD and increased proportionate mortality risks experienced by some occupations (e.g., firefighting and law enforcement). Studies have supported the benefits of physical activity on physiological and psychological health, including the cardiovascular response to acute stress. Aerobically trained individuals exhibit lower sympathetic nervous system (e.g., HR) reactivity and enhanced cardiovascular efficiency (e.g., lower vascular reactivity and decreased recovery time) in response to physical and/or psychological stress. In addition, resistance training has been demonstrated to attenuate cardiovascular responses and improve mental health. This review will examine stress-induced cardiovascular reactivity and plausible explanations for how exercise training and physical fitness (aerobic and resistance exercise) can attenuate cardiovascular responses to stress. This enhanced functionality may facilitate a reduction in the incidence of stroke and myocardial infarction. Finally, this review will also address the interaction of obesity and physical activity on cardiovascular reactivity and CVD.
    Frontiers in Physiology 11/2013; 4:314. DOI:10.3389/fphys.2013.00314 · 3.50 Impact Factor
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    • "Circadian rhythms help maintain homeostasis in a variety of physiological processes, such as the immune, endocrine, cardiovascular, and autonomic nervous systems, and when disrupted may increase susceptibility to disease, including cancer. There is also an elevated prevalence of alcohol use [Violanti et al., 2009a] and obesity [Ramey et al., 2009], and in some cases a reduction in physical activity [Richmond et al., 1998] or sleep quality [Charles et al., 2007a] among police officers compared to general US or other populations. Although the prevalence of smoking among police officers was similar to that of the general US population in one study [Nelson et al., 1994], exposures to other known or suspected carcinogens in this population include traffic-related airborne particulate matter [Riediker et al., 2004], other air pollutants [Hu et al., 2007], and shift work, including nights and rotating shifts [Violanti et al., 2009b; IARC, 2010]. "
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    ABSTRACT: BACKGROUND: This review summarizes peer-reviewed studies examining cancer risks among police officers. It provides an overview of existing research limitations and uncertainties and the plausible etiologic risk factors associated with cancer in this understudied occupation. METHODS: Previous cancer studies among police officers were obtained via a systematic review of the MEDLINE, CABDirect, and Web of Science bibliographic databases. RESULTS: Quality observational studies of cancer among police officers are sparse and subject to limitations in exposure assessment and other methods. Results from three studies suggested possible increased mortality risks for all cancers, and cancers of the colon, kidney, digestive system, esophagus, male breast, and testis, as well as Hodgkin's disease. Few incidence studies have been performed, and results have been mixed, although some associations with police work have been observed for thyroid, skin, and male breast cancer. CONCLUSIONS: Police are exposed to a mix of known or suspected agents or activities that increase cancer risk. Epidemiologic evidence to date is sparse and inconsistent. There is a critical need for more research to understand the biological and social processes underlying exposures and the suggested disproportionate risks and to identify effective prevention strategies. Am. J. Ind. Med. © 2012 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 04/2013; 56(4). DOI:10.1002/ajim.22145 · 1.59 Impact Factor
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    • "Although cortisol can also be measured in urine and blood, saliva has come to be preferred because collection is simple (thus facilitating participant compliance), and because salivary cortisol is unbound (thus providing a biologically active hormone concentration), and it can be readily quantified via immunoassay (Violanti et al., 2009a). Participants collected four serial saliva samples for characterization of the CAR, the first upon awakening, and then at 15-, 30-, and 45-min intervals after waking. "
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    ABSTRACT: Police officers are required to work irregular hours, which induces stress, fatigue, and sleep disruption, and they have higher rates of chronic disease and mortality. Cortisol is a well-known "stress hormone" produced via activation of the hypothalamic-pituitary-adrenal axis. An abnormal secretion pattern has been associated with immune system dysregulation and may serve as an early indicator of disease risk. This study examined the effects of long- and short-term shiftwork on the cortisol awakening response among officers (n = 68) in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) pilot study (2001-2003). The time each officer spent on day (start time: 04:00-11:59 h), afternoon (12:00-19:59 h), or night (20:00-03:59 h) shifts was summarized from 1994 to examination date to characterize long-term (mean: 14 ± 9 yrs) and short-term (3, 5, 7, or 14 days prior to participation) shiftwork exposures. The cortisol awakening response was characterized by summarizing the area under the curve (AUC) for samples collected on first awakening, and at 15-, 30-, and 45-min intervals after waking. Data were collected on a scheduled training or off day. The cortisol AUC with respect to ground (AUC(G)) summarized total cortisol output after waking, and the cortisol AUC with respect to increase (AUC(I)) characterized the waking cortisol response. Officers also completed the Center for Epidemiologic Studies Depression scale. Waking cortisol AUC values were lower among officers working short-term night or afternoon shifts than day shifts, with maximal differences occurring after 5 days of shiftwork. The duration of long-term shiftwork was not associated with the cortisol awakening response, although values were attenuated among officers with more career shift changes.
    Chronobiology International 05/2011; 28(5):446-57. DOI:10.3109/07420528.2011.573112 · 2.88 Impact Factor
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