Association of salivary cortisol levels with cardiovascular diseases

Burmistrov M.E., Burmistrova L.F., Petrov M.V., Komissarenko I.A., Markov V.V.

Cardiovascular diseases continue to be the leading cause of mortality in developed countries, while traditional risk factors do not fully explain the variability in the development and progression of atherosclerosis. In recent decades, significant attention has been paid to the role of chronic psychosocial stress and hypercortisolemia as independent cardiovascular risk factors.

Aim. To evaluate the relationship between morning salivary cortisol concentration and dyslipidemia parameters, anthropometric measurements, and the severity of atherosclerotic lesions of the carotid and coronary arteries in patients with cardiovascular risk factors. Material and methods.  The study included 50 patients with cardiovascular risk factors. All participants underwent salivary cortisol level measurement, lipid profile assessment, and anthropometry. The severity of atherosclerosis was assessed by carotid intima-media thickness (IMT) and by the SYNTAX Score on coronary angiography.

Results.  The mean salivary cortisol level was 8.4±3.2 nmol/L. Statistically significant correlations were found between cortisol level and triglyceride levels, total cholesterol, low-density lipoprotein cholesterol, body mass index, and waist circumference. The strongest associations were observed with markers of atherosclerosis: intima-media thickness and SYNTAX Score. Patients with cortisol levels above the median (>8.1 nmol/L) had significantly higher intima-media thickness values (1.14± 0.18 mm vs. 0.92±0.14 mm, p=0.003) and SYNTAX Score (22.5±8.4 vs. 11.3±6.7, p<0.001).

Conclusion.  Elevated salivary cortisol level, as a marker of chronic hypercortisolemia, is associated with more pronounced manifestations of dyslipidemia (hypertriglyceridemia, impaired lipoprotein ratio), abdominal obesity, and a greater extent of atherosclerotic lesions in major arteries. Salivary cortisol measurement may become a useful tool for cardiometabolic risk stratification.

For citation: Burmistrov ME, Burmistrova LF, Petrov MV et al. Association of salivary cortisol levels with cardiovascular diseases.  International Heart and Vascular Diseases Journal. 2026; 14(50): 27-33. DOI: 10.24412/2311-1623-2026-50-32-39