Subclinical markers of cardiovascular disease among police officers: A longitudinal assessment of the cortisol awakening response and flow mediated artery dilation

Objective: To examine the association of the cortisol awakening response (CAR) with change in brachial artery flow-mediated dilation (FMD%) in police officers over a 7-year period. Methods: Baseline CAR was obtained from four saliva samples taken 15 minutes apart immediately after awakening. Analysis of covariance was used to compare the change in FMD% (FMD% _Follow-up - FMD% _Baseline ) across tertiles of area under the cortisol curve with respect to increase (AUCI). Regression analysis was use to assess trend. Results: Officers (n ¼ 172; 81% men) had a mean SD age of 41 7.6 years. Men in the lowest AUCI tertile (ie, atypical waking cortisol pattern) had a significantly larger 7-year mean decline in FMD% (mean SE: 2.56 0.64) compared with men in the highest tertile (0.89 0.69) (P ¼ 0.0087). Conclusions: An awakening cortisol AUCI predicted worsening of FMD% approximately 7 years later among male officers.