College of Nursing, Michigan State University College of Nursing, East Lansing, Michigan, USA.
J Hypertens. 2023 Jun 1;41(6):875-887. doi: 10.1097/HJH.0000000000003412. Epub 2023 Mar 28.
Stress is widely considered to be a risk factor for high blood pressure (BP), but evidence on the associations between biomarkers of chronic stress and BP is inconsistent. This systematic review and meta-analysis assessed the current state of the science on relationships between measures of cortisol concentration reflecting chronic stress exposure [hair cortisol concentration (HCC), nail cortisol concentration)] and BP.
PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Cochrane Library, and Embase were searched. Random effects models were used to assess the pooled effect size. Exploratory moderation analysis was performed.
Out of 34 014 identified, 16 articles met eligibility criteria and were included in the review, while 14 were included in the meta-analysis. No articles were reported on the association between nail cortisol concentration and BP. Small, positive associations were observed between HCC and SBP [ r = 0.19 (95% confidence interval (CI): 0.08-0.29)] and HCC and DBP [ r = 0.13 (95% CI: 0.04-0.22)]. Cortisol analysis method was identified as a significant moderator of the association between HCC and DBP. HCC was largely, positively associated with hypertension status [odds ratio = 3.23 (95% CI: 2.55-4.09), P < 0.001].
Current evidence suggests that higher HCC may be associated with elevated BP and a potential risk factor for hypertension. However, results should be interpreted with caution because HCC can be affected by hair color, hair care products, and analytic methods. Given the limitations of studies included in this review, further research is needed.
压力被广泛认为是高血压（BP）的一个风险因素，但关于慢性应激生物标志物与 BP 之间的关联的证据并不一致。本系统评价和荟萃分析评估了反映慢性应激暴露的皮质醇浓度测量值（头发皮质醇浓度（HCC）、指甲皮质醇浓度）与 BP 之间关系的现有科学状态。
检索了 PubMed、Cumulative Index to Nursing and Allied Health Literature、Web of Science、Cochrane Library 和 Embase。使用随机效应模型评估汇总效应大小。进行了探索性的调节分析。
在 34014 项中，有 16 项符合纳入标准并被纳入综述，而有 14 项被纳入荟萃分析。没有关于指甲皮质醇浓度与 BP 之间关系的报道。HCC 与 SBP[ r = 0.19（95%置信区间（CI）：0.08-0.29）]和 HCC 与 DBP[ r = 0.13（95% CI：0.04-0.22）]之间存在小的正相关。皮质醇分析方法被确定为 HCC 与 DBP 之间关联的显著调节因素。HCC 与高血压状态高度正相关[比值比=3.23（95%CI：2.55-4.09），P<0.001]。
目前的证据表明，较高的 HCC 可能与血压升高有关，是高血压的潜在危险因素。然而，由于 HCC 可能受到头发颜色、头发护理产品和分析方法的影响，因此结果应谨慎解释。鉴于本综述中纳入的研究存在局限性，需要进一步研究。
