---
title: "Hair cortisol, perceived stress, and resilience as predictors of…"
description: "Hair cortisol levels show a small, inverse association with coronary artery disease risk, but perceived stress and resilience do not independently…"
url: "https://magellanlongevity.com/study/d34652868.md"
canonical: "https://magellanlongevity.com/study/d34652868.html"
html: "https://magellanlongevity.com/study/d34652868.html"
type: "study"
study_key: "d34652868"
journal: "Stress Health"
year: 2021
pmid: "34652868"
doi: "10.1002/smi.3106"
citations: 1
updated: 2026-09-02
author: "Gabriel Radu, DO"
author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765."
publisher: "Magellan Longevity"
content_format: "markdown"
---

# Hair cortisol, perceived stress, and resilience as predictors of coronary arterial disease

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## Citation

| Field | Value |
| --- | --- |
| Journal | Stress Health |
| Year | 2021 |
| PMID | [34652868](https://pubmed.ncbi.nlm.nih.gov/34652868/) |
| DOI | [10.1002/smi.3106](https://doi.org/10.1002/smi.3106) |
| Study key | d34652868 |

## Takeaway

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)?

## Hypothesis

Hair cortisol concentration (HCC) and perceived chronic stress are associated with CAD risk, and psychological and physiological resilience measures may also play a role.

## Methods

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.

## Results

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.

## Conclusion

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.

## Verbatim from the abstract

> Hair cortisol is a promising biomarker for the contribution of chronic stress to coronary arterial disease

## Where this study is used on Magellan

This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions.

| Compound or device | Evidence grade | Graded pages |
| --- | --- | --- |
| Saliva Cortisol Stress Test | Preliminary | [Saliva Cortisol Stress Test](https://magellanlongevity.com/p/149.md) |

## Reference

1. **Hair cortisol, perceived stress, and resilience as predictors of coronary arterial disease**
   Stress Health 2021 · [PMID 34652868](https://pubmed.ncbi.nlm.nih.gov/34652868/) · [DOI 10.1002/smi.3106](https://doi.org/10.1002/smi.3106)

   > Hair cortisol is a promising biomarker for the contribution of chronic stress to coronary arterial disease

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## Related on Magellan Longevity

- [Saliva Cortisol Stress Test](https://magellanlongevity.com/p/149.md) — product graded on this and related evidence
- [Evidence: Hair cortisol (chronic stress)](https://magellanlongevity.com/study/s149.md)
- [Longevity research map](https://magellanlongevity.com/longevity-research-map.html)
- [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md)

## Scope and disclosures

Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication.

Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases.

Reviewed for accuracy by a board-certified physician (DO).