Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai 71800, Negeri Sembilan, Malaysia.
Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang 43000, Selangor, Malaysia.
Int J Environ Res Public Health. 2021 Jan 14;18(2):676. doi: 10.3390/ijerph18020676.
The synthesis and secretion of cortisol are controlled by the hypothalamic-pituitary-adrenal axis. Cortisol exhibits a proper 24-h circadian rhythm that affects the brain, the autonomic nervous system, the heart, and the vasculature that prepares the cardiovascular system for optimal function during these anticipated behavioral cycles. A literature search was conducted using databases such as Google Scholar, PubMed, and Scopus. Relevant search terms included "circadian rhythm and cardiovascular", "cortisol", "cortisol and acute coronary syndrome", "cortisol and arrhythmias", "cortisol and sudden cardiac death", "cortisol and stroke", and "cardioprotective agents". A total of 120 articles were obtained on the basis of the above search. Lower levels of cortisol were seen at the beginning of sleep, while there was a rise towards the end of sleep, with the highest level reached at the moment the individual wakes up. In the present review, we discuss the role of 11β-hydroxysteroid dehydrogenase (11β-HSD1), which is a novel molecular target of interest for treating metabolic syndrome and type-2 diabetes mellitus. 11β-HSD1 is the major determinant of cortisol excess, and its inhibition alleviates metabolic abnormalities. The present review highlights the role of cortisol, which controls the circadian rhythm, and describes its effect on the cardiovascular system. The review provides a platform for future potential cardioprotective therapeutic agents.
皮质醇的合成和分泌受下丘脑-垂体-肾上腺轴的控制。皮质醇表现出适当的 24 小时昼夜节律，影响大脑、自主神经系统、心脏和血管，为这些预期的行为周期中心血管系统的最佳功能做好准备。使用 Google Scholar、PubMed 和 Scopus 等数据库进行了文献检索。相关搜索词包括“昼夜节律与心血管”、“皮质醇”、“皮质醇与急性冠状动脉综合征”、“皮质醇与心律失常”、“皮质醇与心源性猝死”、“皮质醇与中风”和“心脏保护剂”。根据上述搜索共获得了 120 篇文章。在睡眠开始时皮质醇水平较低，而在睡眠结束时皮质醇水平上升，在个体醒来时达到最高水平。在本综述中，我们讨论了 11β-羟类固醇脱氢酶（11β-HSD1）的作用，它是治疗代谢综合征和 2 型糖尿病的新的有前途的分子靶标。11β-HSD1 是皮质醇过多的主要决定因素，其抑制可减轻代谢异常。本综述强调了皮质醇的作用，它控制着昼夜节律，并描述了它对心血管系统的影响。该综述为未来潜在的心脏保护治疗剂提供了一个平台。
