Can hair cortisol concentration (HCC), perceived chronic stress, and resilience predict the risk of coronary arterial disease (CAD)?
Saliva Cortisol Stress Test, a cross-sectional study in 24 participants (Stress Health 2021, PMID 34652868) — hair cortisol concentration (HCC) was significantly associated with CAD (incident rate ratio 0.99, confidence interval 0.98-1.00, p = 0.01), but the association was weak and inverse. Perceived Stress Score was not significantly associated with CAD.
Source: Stress Health 2021, PMID 34652868 ↗ · Research map · How Magellan grades evidence · evidence confidence: high
Stress Health · 2021 · PMID 34652868 · DOI 10.1002/smi.3106
Hair cortisol levels show a small, inverse association with coronary artery disease risk, but perceived stress and resilience do not independently predict it.
The question
Can hair cortisol concentration (HCC), perceived chronic stress, and resilience predict the risk of coronary arterial disease (CAD)?
What they tested
Hair cortisol concentration (HCC) and perceived chronic stress are associated with CAD risk, and psychological and physiological resilience measures may also play a role.
How they did it
This was a cross-sectional study of 24 participants. The researchers assessed the risk of CAD associated with HCC and perceived chronic stress (Perceived Stress Score), controlling for age, diabetes, hypertension, dyslipidemia, and obesity. They also evaluated CAD risk with the simultaneous inclusion of psychological and physiological resilience measures (CD-RISC, DHEA-S) in fully adjusted Poisson regression models.
What they found
Hair cortisol concentration (HCC) was significantly associated with CAD (incident rate ratio 0.99, confidence interval 0.98-1.00, p = 0.01), but the association was weak and inverse. This association was less pronounced than with dyslipidemia and age. Perceived Stress Score was not significantly associated with CAD. The association between HCC and CAD remained significant after including a combined resiliency score, but resilience itself was not independently significantly associated with CAD.
What it means
Hair cortisol concentration (HCC) contributes a small amount to CAD risk in an average-risk population, even after adjusting for multisystem resilience. Perceived stress and resilience measures were not independently significant predictors of CAD in this study.
Limitations
The study was cross-sectional and involved a small sample size of 24 participants. The magnitude of the association between HCC and CAD was weak and inverse.
The paper at a glance
| Title | Hair cortisol, perceived stress, and resilience as predictors of coronary arterial disease |
|---|---|
| Journal | Stress Health |
| Year | 2021 |
| PMID | 34652868 ↗ |
| DOI | 10.1002/smi.3106 ↗ |
| Topic | Sleep, circadian rhythm & stress |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
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Saliva Cortisol Stress Test
Across large studies, dysregulated cortisol patterns track with worse health: a meta-analysis found flatter daily cortisol slopes are associated with poorer mental and physical health, the Whitehall II cohort linked flatter salivary slopes to higher all-cause and cardiovascular mortality, and elevated hair cortisol…
Cortisol is the body's primary glucocorticoid stress hormone, produced by the adrenal glands under the…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). Can hair cortisol concentration (HCC), perceived chronic stress, and resilience predict the risk of coronary arterial disease (CAD)? [Plain-English summary of Stress Health 2021, PMID 34652868, DOI 10.1002/smi.3106]. Magellan Longevity. https://magellanlongevity.com/study/d34652868.html@misc{magellan_d34652868,
title = {Can hair cortisol concentration (HCC), perceived chronic stress, and resilience predict the risk of coronary arterial disease (CAD)?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/d34652868.html}},
note = {Plain-English summary of PubMed PMID 34652868; DOI 10.1002/smi.3106; Stress Health 2021. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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