Resting neuroendocrine markers in relation to acute mental stress‐induced adrenergic reactivity profiles in adults: The <scp>SABPA</scp> study

Abstract

Stress-induced hemodynamic reactivity was categorized as predominant alpha (α)- and beta (β)-adrenergic reactivity profiles. Within these profiles, we investigated resting neuroendocrine markers, their associations with hemodynamic reactivity, and odds of an α- or β-adrenergic reactivity profile. We included 375 teachers (20-65 years) and recorded one-minute beat-to-beat hemodynamic reactivity during Stroop-Color-Word-Conflict-test. We categorized α-responders [lowest-quartile ∆%CO, ∆%Cwk; n = 49], β-responders [highest-quartile ∆%CO, ∆%Cwk; n = 69], mixed-α/β-responders [remaining n = 257]. Baseline fasting serum adrenocorticotropic hormone (ACTH), cortisol, urinary norepinephrine-to-creatinine (u-NE/Cr), and epinephrine-to-creatinine (u-EPI/Cr) ratios were measured. Predominant α-responders were older with greater hypertension prevalence than other responders. In α-responders, u-NE/Cr inversely, and ACTH and cortisol positively associated with ∆%CO and ∆%Cwk (all p ≤ 0.044). In β-responders, u-NE/Cr positively associated with ∆%CO, u-EPI/Cr inversely with ∆%CO, and positively with ∆%Cwk (all p ≤ 0.045). Odds of an α-profile were higher with u-NE/Cr, ACTH, and cortisol in the highest-quartile (all p ≤ 0.004). Odds of a β-profile were higher with u-NE/Cr in the highest-quartile and ACTH and cortisol in the lowest-quartile (all p ≤ 0.006). Predominant α-responders exhibited higher u-NE/Cr, ACTH, and cortisol, suggesting vascular risk through peripheral vasoconstriction. Predominant β-responders showed higher u-NE/Cr only, suggesting adaptive cardiac performance via catecholaminergic drive. These findings reveal distinct neuroendocrine underpinnings with implications for personalized acute stress cardiovascular phenotyping.