To test the hypothesis that Type-D
personality is associated with elevated cortisol
levels in patients 4 months after an acute coronary syndrome (ACS).
profiles were measured at home in 70 coronary heart disease patients (Mean age = 60.90 years, SD = 10.7, 17% female) 4 months after hospitalization for ACS. Eight saliva samples were taken over the course of 1 day.
Thirty eight percent of the ACS patients were defined as Type-D
profiles showed a typical diurnal pattern, with low levels in the evening, high levels early in the day. Type-D
was not related to the cortisol
awakening response, but cortisol
output the day was higher in Type-D
(mean = 4443.3, SD = 2334.1 nmol/l) than non Type-D
patients (mean = 3252.0, SD = 1810.2 nmol/l) after adjustment for age, gender, hypertension, Global Registry of Acute Coronary Events risk score, recurrence of cardiac symptoms, previous myocardial infarction, body mass index and concurrent depressed mood (p
= .044). Type-D
personality accounted for 6% over the variance in cortisol
output over the day, after covariates had been taken into account.
personality may be associated with prolonged disruption of the hypothalamic-pituitary-adrenal axis function in survivors of acute cardiac events and may contribute to biological responses influencing future cardiac morbidity.
MI = myocardial infarction; BMI = body mass index; ACS = acute coronary syndrome; CAR = cortisol awakening response; HPA = hypothalamic-pituitary-adrenal axis; SD = standard deviation; GRACE = global registry of acute coronary events.