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. 2024 May 21:15:1397062.
doi: 10.3389/fendo.2024.1397062. eCollection 2024.

Daytime plasma cortisol and cortisol response to dexamethasone suppression are associated with a prothrombotic state in hypertension

Gabriele Brosolo #  1 , Andrea Da Porto #  2 , Luca Bulfone  1 , Antonio Vacca  1 , Nicole Bertin  3 , Cinzia Vivarelli  1 , Cristiana Catena #  1 , Leonardo A Sechi #  1   2   3
Affiliations

Daytime plasma cortisol and cortisol response to dexamethasone suppression are associated with a prothrombotic state in hypertension

Gabriele Brosolo et al. Front Endocrinol (Lausanne). .

Abstract

Background and aims: A prothrombotic state was demonstrated in patients with Cushing's syndrome and is involved in the development and progression of cardiovascular and renal damage in hypertensive patients. This study was designed to examine the relationships between cortisol secretion and the hemostatic and fibrinolytic systems in hypertension.

Methods: In 149 middle-aged, nondiabetic, essential hypertensive patients free of cardiovascular and renal complications, we measured hemostatic markers that express the spontaneous activation of the coagulation and fibrinolytic systems and assessed daily cortisol levels (8 AM, 3 PM, 12 AM; area under the curve, AUC-cortisol) together with the cortisol response to dexamethasone overnight suppression (DST-cortisol).

Results: Plasma levels of D-dimer (D-dim), prothrombin fragment 1 + 2 (F1 + 2), and von Willebrand factor (vWF) were progressively and significantly higher across tertiles of AUC-cortisol and DST-cortisol, whereas no differences were observed in fibrinogen, tissue plasminogen activator, plasminogen activator inhibitor-1, antithrombin III, protein C, and protein S. D-dim, F1 + 2, and vWF were significantly and directly correlated with age and both AUC-cortisol and DST-cortisol. Multivariate regression analysis showed that both AUC-cortisol and DST-cortisol were related to plasma D-dim, F1 + 2, and vWF independently of age, body mass index, blood pressure, and renal function.

Conclusion: Greater daily cortisol profile and cortisol response to overnight suppression are independently associated with a prothrombotic state in hypertensive patients and might contribute to the development of organ damage and higher risk of cardiovascular complications.

Keywords: coagulation; cortisol; d-dimer; dexamethasone; fibrinogen; fibrinolysis; prothrombin fragment 1 + 2; von Willebrand factor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Relationships between the area under the curve (AUC) of daily (8 AM, 3 PM, 12 AM) plasma cortisol and log-transformed D-dimer, prothrombin fragment 1 + 2, and von Willebrand factor.
Figure 2
Figure 2
Relationships between log-transformed plasma cortisol measured after a 1 mg overnight dexamethasone suppression test (DST-cortisol) and log-transformed D-dimer, prothrombin fragment 1 + 2, and von Willebrand factor.
See this image and copyright information in PMC

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