Study links high levels of stress hormones to increased blood pressure, cardiovascular events

Middle-aged woman places her hand on her face during stressful moment.

Adults with normal blood pressure and high levels of stress hormones are more likely to develop high blood pressure and experience cardiovascular events, including heart attack and stroke, compared to those who had lower stress hormone levels, according to a study published in the journal Hypertension.  

Past studies have shown a link between stress hormone levels and high blood pressure or cardiovascular events in people with existing hypertension. However, studies of this connection in people with normal blood pressure are lacking. 

To find out more, the researchers studied participants in the NHLBI’s Multi-Ethnic Study of Atherosclerosis (MESA), which aims to identify factors that contribute to heart disease that occur with or without obvious symptoms.  In this MESA substudy, the researchers selected adults with normal blood pressure and analyzed levels of various hormones known to respond to stress. In particular, they analyzed levels of norepinephrine, epinephrine, dopamine—collectively known as catecholamines—hormones that regulate body functions such as heart rate, blood pressure, and breathing. They also analyzed levels of cortisol, a steroid hormone released when one experiences stress.  They measured these hormone levels in a 12-hour overnight urine test. In all, the study included 412 adults ages 48 to 87 years. About half were female, 54% were Hispanic, 22% were black, and 24% were white.  

In general, those who had high levels of stress hormones in their urine were more likely to develop high blood pressure over the next 6-7 years, the researchers said.  Of particular concern in the study were urinary cortisol levels. The researchers found that over an 11 year follow-up period, there was a 90% increased risk of cardiovascular events with each doubling of cortisol levels.   

The study suggests the possible need for routine measurement of stress hormones in an effort to prevent hypertension and cardiovascular events, researchers say. It was funded in part by the NHLBI.