Functionality of the hypothalamus-pituitary-adrenal axis in essential hypertension: Cortisol response to awakening and negative feedback sensitivity

Project leader: Petra Wirtz
Project duration: 2003 – 2005
Funding: Foundation for Research in Science and the Humanities at the University of Zurich (2003 to PW)

Essential hypertension is considered one of the most important risk factors in the development of cardiovascular disease as well as the underlying process of arteriosclerosis. The mechanisms that cause hypertensive individuals to develop above-average levels of arteriosclerosis have not been fully uncovered.
The project examined the functionality of the hypothalamus-pituitary-adrenal axis (HPA) in essential hypertension. Besides the cortisol awakening response (CAR) and circadian cortisol profiles, the negative feedback sensitivity of the HPA in reaction to a dexamethasone suppression test was also investigated. In comparison with healthy control subjects, the results show both a blunted cortisol awakening response and reduced HPA inhibition in individuals with essential hypertension who received dexamethasone. Changes in HPA regulation could also lead to increased arteriosclerotic risk in essential hypertension.

Wirtz, P.H., von Känel, R., Emini, L., Ruedisueli, K., Groessbauer, S., Maercker, A.,& Ehlert, U. (2007). Evidence for altered hypothalamus-pituitary-adrenal axis functioning in systemic hypertension: blunted cortisol response to awakening and lower negative feedback sensitivity. Psychoneuroendocrinology 32:430-436. [Link]