Currently, the potential for cardiovascular (CV) stress-induced risk is primarily
based on the theoretical (obvious) side effects of stress on the CV system. Salivary
cortisol and α-amylase, produced respectively by the hypothalamus-pituitary-adrenal
(HPA) axis and the sympathetic-adrenomedullary (SAM) system during stress response,
are still not included in the routine evaluation of CV risk and require additional
and definitive validation. Therefore, this article overviews studies published
between 2010 and 2015, in which salivary cortisol and α-amylase were measured as
stress biomarkers to examine their associations with CV/CMR (cardiometabolic risk)
clinical and subclinical indicators. A comprehensive search of PubMed, Web of Science
and Scopus electronic databases was performed, and 54 key articles related to the use
of salivary cortisol and α-amylase as subclinical indicators of stress and CV/CMR
factors, including studies that emphasized methodological biases that could influence
the accuracy of study outcomes, were ultimately identified. Overall, the biological
impact of stress measured by salivary cortisol and α-amylase was associated with
CV/CMR factors. Results supported the use of salivary cortisol and α-amylase as
potential diagnostic tools for detecting stress-induced cardiac diseases and
especially to describe the mechanisms by which stress potentially contributes to the
pathogenesis and outcomes of CV diseases.
IntroductionThe vestibular acute stress induces reversible alert-like reactions that involve the sympathetic adrenal-medullar system and hypothalamic-pituitary-adrenal axis responses. The present study aimed to evaluate salivary α-amylase and salivary cortisol production in relation with cardiovascular reactivity induced by acute stress in healthy subjects.Material and methodsForty-eight young healthy male volunteers were examined under basal conditions and at various times after reaching the maximal nystagmic reaction following air caloric vestibular test. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded at the same time as measurement of the salivary α-amylase and salivary cortisol. At the end of the caloric vestibular test session, perceived stress scale questionnaires were administered to measure the self-perceived stress impact induced by the task, and individual scores were compared with those measured on the enrollment day.ResultsFollowing caloric vestibular test-evoked vertigo, salivary α-amylase and cortisol showed distinct trends in their production after acute stress: Student’s t-test was used to compare the α-amylase vs cortisol slopes of the respective interpolated regression lines, and the difference was significant (t = -3.283; p<0.001); an increase in salivary cortisol production corresponded with a decrease in the salivary α-amylase concentration. In addition, salivary biomarker modifications were associated with consistent changes in the heart rate, systolic blood pressure and mean arterial pressure.ConclusionsUsing the air caloric vestibular test task as a stressor, the present study demonstrated a connection between the acute hormonal stress response to vestibular stimulation and cardiovascular output. However, further research is needed before we can define the potential importance of the consistent cardiovascular activity changes evoked by vestibular stimulation and the possible functional consequences for cardiovascular regulation and orthostatic tolerance in humans.
There is an increasing interest in the analysis of salivary biomarkers for medical practice. The objective of this article was to identify the specificity and sensitivity of quantification methods used in biosensors or portable devices for the determination of salivary cortisol and salivary a-amylase. There are no biosensors and portable devices for salivary amylase and cortisol that are used on a large scale in clinical studies. These devices would be useful in assessing more real-time psychological research in the future.
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