Adrenocortical and Gonadal Steroids in Behavioral Cardiovascular Medicine

  • Cynthia M. Kuhn
Part of the The Springer Series in Behavioral Psychophysiology and Medicine book series (SSBP)


The purpose of this chapter is to provide guidelines for the evaluation of steroid hormone secretion as they relate to cardiovascular function. As aldosterone is covered elsewhere in a discussion of renin—angiotensin—aldosterone secretion (see Atlas, this volume), this chapter will focus on glucocorticoid and gonadal steroids. Parameters relevant to cardiovascular function are emphasized rather than classical endocrinologic methods for assessing adequacy of hormone secretion. This involves somewhat different strategies, as changes in hormone secretion rather than absolute hormone levels are of considerable importance, particularly in understanding the role of behavioral variables in cardiovascular disease.


Plasma Cortisol Cardiovascular Function Corticotropin Release Factor Cortisol Secretion Gonadal Steroid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abplanalp, J. M., Livingston, L., Rose, R., & Sanwisch, D. (1977). Cortisol and growth hormone responses to psychological stress during the menstrual cycle. Psychosomatic Medicine, 39, 158–177.PubMedGoogle Scholar
  2. Abraham, G. E. (Ed.). (1974). Radioimmunoassay of steroids in biological fluids. Acta Endocrinologica Supplementum, 183.Google Scholar
  3. Adams, M. R., Kaplan, J. R., Clarkson, T. B., & Koritnik, D. R. (1984). Ovariectomy, social status and atherosclerosis in cynomolgus monkeys. Arteriosclerosis, 5, 192–200.Google Scholar
  4. Bjorkerud, S. (1974). Effect of adrenocortical hormones on the integrity of rat aortic endothelium. In Shettler, G., & Weizler, A. (Eds.), Atherosclerosis III (pp. 245–249). Berlin: Springer.Google Scholar
  5. Bondy, P. K., & Rosenberg, L. (1980). Metabolic control and disease (8th ed.). Philadelphia: Saunders.Google Scholar
  6. Chearskul, S., Rincon-Rodriguez, I., Sofi, S. B., Donaldson, A., & Jeffcoate, L. (1982). Simple, direct assays for the measurement of estradiol and progesterone in saliva, In Radioimmunoassay and related procedures in medicine (pp. 265–274). Vienna: IAEA.Google Scholar
  7. Christiansen, K., Knussmann, R., & Couwenbergs, C. (1985). Sex hormones and stress in the human male. Hormones and Behavior, 19, 426–440.PubMedCrossRefGoogle Scholar
  8. Collins, A., Eneroth, P., & Landgren, B. M. (1985). Psychoneuroendocrine stress responses and mood as related to the menstrual cycle. Psychosomatic Medicine, 47, 512–527.PubMedGoogle Scholar
  9. Estep, H. L., Island, D. P., Neu, R. L., & Liddle, G. W. (1968). Pituitary adrenal dynamics during surgical states. Journal of Clinical Endocrinology and Metabolism, 23, 419–425.CrossRefGoogle Scholar
  10. Ferguson, D. B. (1984). Physiological considerations in the use of salivary steroid estimation for clinical investigations. Frontiers of Oral Physiology, 5, 1–20.Google Scholar
  11. Frankenhaeuser, M. (1982). The sympathetic and pituitaryadrenal response to challenge: Comparison between the sexes. In T. Dembroski, T. H. Schmidt, & G. Blumchen (Eds.), Biobehavioral basis of coronary heart disease (pp. 91–106). Basel: Karger.Google Scholar
  12. Frederikson, M., Sundin, O., & Frankenhaeuser, M. (1985). Cortisol excretion during the defense reaction in humans. Psychosomatic Medicine, 47, 313–319.Google Scholar
  13. Friedman, M., George, S., Byers, S. O., & Rosenman, R. H. (1960). Excretion of catecholamines, 17-ketosteroids, 17-hydroxycorticoids and 5-hydroxyindole in men exhibiting a particular behavior pattern (A) associated with high incidence of clinical coronary artery disease. Journal of Clinical Investigation, 39, 758–764.PubMedCrossRefGoogle Scholar
  14. Gray, G. D., Smith, E. R., Damassa, D. A., Ehrenkranz, J. R. L. & Davidson, J. M. (1978). Neuroendocrine mechanisms mediating the suppression of circulating testosterone levels associated with chronic stress in male rats. Neuroendocrinology, 25, 247–256.PubMedCrossRefGoogle Scholar
  15. Griffin, J. E., & Wilson, J. D. (1980). The testis. In P. K. Bondy & L. E. Rosenberg (Eds.), Metabolic control and disease (pp. 1535–1620). Philadelphia: Saunders.Google Scholar
  16. Hartley, H. L., Mason, J. W., Hogan, R. P., Jones, L. G., Kotchen, T. A., Moughey, E. H., Wherry, F. E., Pennington, L. L., & Ricketts, P. T. (1972). Multiple hormonal responses to graded exercise in relation of physical training. Journal of Applied Physiology, 33, 602–606.PubMedGoogle Scholar
  17. Hastrup, J. L., & Light, K. C. (1984). Sex differences in cardiovascular stress responses: Modulation as a function of menstrual cycle phases. Journal of Psychosomatic Research, 28, 475–483.PubMedCrossRefGoogle Scholar
  18. Hazzard, W. R. (1984). The sex differential in longevity. In R. A. Andres & E. L. Bierman (Eds.), Principles of geriatric medicine (pp. 72–81). New York: McGraw-Hill.Google Scholar
  19. Hazzard, W. R. (1985). Atherogenesis: Why women live longer. Geriatrics, 40, 42–54.PubMedGoogle Scholar
  20. Hellhammer, D. H., Hubert, W., & Schurmeyer, H. T. (1985). Changes in saliva testosterone after psychological stimulation in men. Psychoneuroendocrinology, 10, 77–81.PubMedCrossRefGoogle Scholar
  21. Henry, J. P., Stephens, P. M., & Santisteban, G. A. (1975). A model of psychosocial hypertension showing reversibility and progression of cardiovascular complications. Circulation Research, 36, 156–164.PubMedCrossRefGoogle Scholar
  22. Henry, J. P., Kross, M. E., Stephens, P. M., & Watson, F. M. C. (1976). Evidence that differing psychosocial stimuli lead to adrenal cortical stimulation by autonomic or endocrine pathways. In E. Usdin (Ed.), Catecholamines and stress (pp. 457–468). New York: Raven Press.Google Scholar
  23. Jeffcoate, S. L. (1975). Methods of hormone analysis. New York: Wiley.Google Scholar
  24. Kaplan, J. R., Manuck, S. B., Clarkson, T. B., Lusso, T. B., & Taub, D. M. (1982). Social status environment in atherosclerosis in cynomolgus monkeys. Arteriosclerosis, 2, 359–367.PubMedCrossRefGoogle Scholar
  25. Kaplan, J. R., Adams, M. R., Clarkson, T. B., & Koritnik, D. R. (1984). Psychosocial influences on female protection among cynomolgus macaques. Atherosclerosis, 53, 283–295.PubMedCrossRefGoogle Scholar
  26. Kawakami, M., Kubo, K., Uemura, T., Nagase, M., & Hayashi, R. (1981). Involvement of ovarian innervation in steroid secretion. Endocrinology, 109, 136–145.PubMedCrossRefGoogle Scholar
  27. Klaibern, E. L., Broverman, D. M., Haffajee, C. I., Hochman, J. S., Sacks, G. M., & Dalen, J. E. (1982). Serum estradiol levels in men with acute myocardial infarction. American Journal of Medicine, 73, 872–881.CrossRefGoogle Scholar
  28. Knopp, R. H., Waiden, C. E., & Wahl, P. W. (1981). Oral contraceptive and postmenopausal estrogen effects on lipoprotein triglyceride and cholesterol in an adult female population: Relationships to estrogen and progestin potency. Journal of Clinical Endocrinology and Metabolism, 53, 1123–1132.PubMedCrossRefGoogle Scholar
  29. Kreuz, M. A. J., Rose, R. M., & Jennings, J. R. (1972). Suppression of plasma testosterone levels and pyschological stress, Archives of General Psychology, 26, 479–482.CrossRefGoogle Scholar
  30. Landon, J., Smith, D. S., Perry, L. A., & Al-Ansari, A. A. K. (1984). The assay of salivary cortisol. In G. F. Read, D. Read-Fahmy, R. F. Walker, & K. Griffiths (Eds.), Immunoassays of steroids in saliva (pp. 301–307). London: Alpha Omega Publishing.Google Scholar
  31. Leshner, A. I. (1980). The interaction of experience and neuroendocrine factors in determining behavioral adaptations to aggression. Progress in Brain Research, 53, 427–438.PubMedCrossRefGoogle Scholar
  32. Lewis, J. G., & Elder, P. A. (1985). An enzyme-linked immunosorbent assay (ELISA) for plasma cortisol. Journal of Steroid Biochemistry, 22, 673–676.PubMedCrossRefGoogle Scholar
  33. Luisi, M., Bernini, G. P., Del Genovese, A., Birindelli, R., Barletta, D., Gasperi, M., & Franchi, F. (1980). Radioimmunoassay for free testosterone in human saliva. Journal of Steroid Biochemistry, 12, 513–516.PubMedCrossRefGoogle Scholar
  34. Luria, M. H., Johnson, M. W., Pego, R., Seuc, C. A., Manubens, S. J., Wieland, M. R., & Wieland, R. G. (1982). Relationship between sex hormones, myocardial infarction and occlusive coronary disease. Archives of Internal Medicine, 142, 42–44.PubMedCrossRefGoogle Scholar
  35. Mason, J. W., Kenion, C. C., Collins, D. R., Mougey, E. H., Jones, J. A., Driver, G. C., Brady, J. V., & Beer, B. (1968). Urinary testosterone response to 72-hr avoidance session in the monkey. Psychosomatic Medicine, 30, 721–732.PubMedGoogle Scholar
  36. Mason, J. W., Hartley, L. H., Kotchen, T. A., Moughey, E. H., Ricketts, P. T., & Jones, L. G. (1973). Plasma cortisol and norepinephrine responses in anticipation of muscular exercise. Psychosomatic Medicine, 35, 406–414.PubMedGoogle Scholar
  37. Murphy, B. E. P. (1968). Clinical evaluation of urinary cortisol determinations by competitive protein binding. Journal of Endocrinology and Met. 28, 343–348.CrossRefGoogle Scholar
  38. Murphy, B. E. P., Engelberg, W., & Patter, C. J. (1963). Simple method for determination of plasma corticoids. Journal of Clinical Endocrinology and Metabolism, 23, 293–300.PubMedCrossRefGoogle Scholar
  39. Nakashima, A., Koshiyama, K., Uozimi, T., Monden, Y., Hamanaka, Y., Kurachi, K., Aono, T., Mizutani, X., & Matsumoto, K. (1975). Effects of general anaesthesia and severity of surgical stress on serum LH and testosterone in males. Acta Endocrinologica, 78, 258–269.PubMedGoogle Scholar
  40. Nieschlag, E., & Wickins, E. J. (1978). The role of testosterone in the evaluation of testicular function. In G. E. Abraham (Ed.), Radioassay systems in clinical endocrinology (pp. 169–196). New York: Dekker.Google Scholar
  41. Orth, D. N., Jackson, R. V., DeCherney, G. S., DeBold, C. R., Alexander, A. N., Island, D. P., Rivier, J., Rivier, C., Speiss, J., & Vale, W. (1983). Effects of ovine synthetic corticotropin releasing factor: Dose response of plasma adrenocorticotropin and cortisol. Journal of Clinical Investigation, 71, 587–595.PubMedCrossRefGoogle Scholar
  42. Phillips, G. B., Castell, W. P., Abbott, R. D., & McNamara, P. M. (1983). Association of hyperestrogenemia and coronary heart disease in men in the Framingham cohort. American Journal of Medicine, 74, 863–869.PubMedCrossRefGoogle Scholar
  43. Pinter, E. J., Peterfy, G., & Cleghorn, J. M. (1975). Studies in endocrine and affective functions in complex flight manoeuvres. Psychotherapy and Psychosomatics, 26, 93–100.PubMedCrossRefGoogle Scholar
  44. Read-Fahmy, D., Read, G. F., & Walker, R. F. (1982). Steroids in saliva for assessing endocrine function. Endocrine Reviews, 3, 367–395.CrossRefGoogle Scholar
  45. Ritchie, J. C., Varroll, B. J., Olton, P. R., Shively, V., & Feinberg, M. (1985). Plasma cortisol determination for the dexamethasone suppression test. Archives of General Psychiatry, 42, 493–497.PubMedCrossRefGoogle Scholar
  46. Rose, R. M., & Hurst, M. W. (1975). Plasma cortisol and growth hormone responses to intravenous catheterization. Journal of Human Stress, 1, 22–36.PubMedCrossRefGoogle Scholar
  47. Rose, R. M., Gordon, T. P., & Bernstein, I. S. (1972). Plasma testosterone levels in the male rhesus monkey: Influence of sexual and social stimuli. Science, 178, 643–645.PubMedCrossRefGoogle Scholar
  48. Rose, R. M., Jenkins, D., Hurst, M., Livingston, L., & Hasell, R. P. (1982). Endocrine activity in air traffic controllers at work. 1. Characterization of cortisol and growth hormone levels during the day. Psychoneuroendocrinology, 7, 101–111.PubMedCrossRefGoogle Scholar
  49. Rosenfeld, S., Marmorston, J., Sobel, H., & White, A. E. (1960). Enhancement of experimental atherosclerosis by ACTH in the dog. Proceedings of the Society for Experimental Biology and Medicine, 103, 83–86.PubMedCrossRefGoogle Scholar
  50. Schomig, A., Luth, B., Dietz, R., & Gross, F. (1976). Changes in vascular smooth muscle sensitivity to vasoconstrictor agents induced by corticosteroids, adrenalectomy, and differing salt intake in rats. Clinical Science and Molecular Medicine, 51, 51–63.Google Scholar
  51. Silber, R. H., & Porter, C. C. (1954). The determination of 17, 21-dihydroxy-20-ketosteroids in urine and plasma. Journal of Biological Chemistry, 210, 923–932.PubMedGoogle Scholar
  52. Steger, R. W. (1982). Age dependent changes in the responsiveness of the reproductive system to pharmacologic agents. Pharmacology and Therapeutics, 17, 1–64.PubMedCrossRefGoogle Scholar
  53. Streeten, D. H. P., Anderson, G. H., Dalakos, T. G., Seeley, D., Mallov, J. S., Eusebio, R., Sunderlin, F. S., Badawy, S. Z. A., & King, R. B. (1982). Normal and abnormal function of the hypothalamic-pituitary adrenocortical system in man. Endocrine Reviews, 5, 371–394.CrossRefGoogle Scholar
  54. Surwit, R. S., Allen, L. M., Gilgor, R. S., Schanberg, S., Kuhn, C., & Duvuc, M. (1982). Neuroendocrine response to cold in Raynaud’s syndrome. Life Sciences, 32, 995–1000.CrossRefGoogle Scholar
  55. Thorneycroft, I. H., Mishell, D. R., Stone, S. C., Kharma, K. M., & Nakamura, R. M. (1971). The relation of serum 17-hydroxyprogesterone and estradiol-17-beta levels during the human menstrual cycle. American Journal of Obstetrics and Gynecology, 111, 947–951.PubMedGoogle Scholar
  56. Troxler, R. G., Sprague, E. A., Albanese, R. A., Fuchs, R., & Thompson, A. J. (1977). The association of elevated plasma cortisol and early atherosclerosis as demonstrated by coronary angiography. Atherosclerosis, 26, 151–162.PubMedCrossRefGoogle Scholar
  57. Umeda, T., Hiramatsu, R., Iwaoka, T., Shimada, T. R., Miura, R., & Sato, T. (1981). Use of saliva for monitoring unbound free cortisol levels in serum. Clinica Chimica Acta, 110, 245–253.CrossRefGoogle Scholar
  58. Walker, R. F., Joyce, B. G., Dyas, J., & Read-Fahmy, D. (1984). Cortisol: Monitoring changes in normal adrenal activity. In G. F. Read, D. Read-Fahmy, R. F. Walker, & K. Griffiths (Eds.), Immunoassay of steroids in saliva (pp. 309–324). London: Alpha Omega Publishing.Google Scholar
  59. Weitzman, E. D., Fukushima, D., Nogeire, C., Roffwarg, H., Gallagher, T. F., & Hellman, L. (1971). 24 hour pattern of the episodic secretion of cortisol in normal subjects. Journal of Clinical Endocrinology and Metabolism, 33, 14–22.PubMedCrossRefGoogle Scholar
  60. Williams, R. B., Lane, J. D., Kuhn, C. M., Melosh, W., White, A. D., & Schanberg, S. (1982). Type A behavior and elevated physiological and neuroendocrine responses to cognitive tasks. Science, 218, 483.PubMedCrossRefGoogle Scholar
  61. Wilson, J. D., & Foster, D. W. (1980). Williams textbook of endocrinology. Philadelphia: Saunders.Google Scholar
  62. Yen, S. S. C., & Jaffe, R. B. (1986). Reproductive endocrinology. Philadelphia: Saunders.Google Scholar
  63. Zumoff, B., Fukushima, D. K., & Hellman, L. (1974). Intercomparison of four methods for measuring cortisol production. Journal of Clinical Endocrinology and Metabolism, 38, 169–180.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1989

Authors and Affiliations

  • Cynthia M. Kuhn
    • 1
  1. 1.Department of PharmacologyDuke University Medical CenterDurhamUSA

Personalised recommendations