Hair cortisol concentration in patients with Takotsubo syndrome was twice as high as in clinically stable controls (7.3 vs. 3.5 pg/mg, p < .01), indicating increased chronic stress.
Is chronic physiological stress (measured by hair cortisol concentration) associated with the onset of Takotsubo syndrome?
Patients with a recent Takotsubo syndrome episode have significantly higher hair cortisol concentrations compared to controls, suggesting a role for chronic physiological stress in its onset.
Abstract Aims To study whether chronic physiological stress may play a role in the onset of Takotsubo Syndrome (TS) and whether it is associated with worse psychological distress in patients recovering from a recent TS episode. Methods and results We compared hair cortisol concentration (HCC), a validated biomarker of chronic stress, between a group of patients recently admitted with a new diagnosis of TS (Mayo criteria) and a cohort of clinically stable historical controls. HCC, demographics, perceived stress, depression, anxiety, PTSD symptoms, and trigger history were assessed approximately 4 weeks after discharge. Descriptive statistics and linear regression models were used to assess associations. Participants (n=59) had a mean age of 64.5 years and were mostly non-Hispanic White (94.9%) and female (96.6%). A large proportion of participants had a history of psychiatric disorders (62.7%), including anxiety disorders (40.7%) and mood disorders (39.0%). The HCC in the TS sample was twice as high as that of clinically stable controls (geometric mean: 7.3 pg/mg (SD 2.9) vs. 3.5 pg/mg (SD 3.7), p .01). We found that patients with higher HCC did not report a history of triggers prior to TS onset or greater psychological distress post-discharge. Conclusions Patients with a recent TS episode had significantly higher HCC compared to clinically stable controls, suggesting that chronic physiological stress may play a role in the onset of TS. These preliminary findings support further investigation into the effects of stress-reduction approaches for the prevention of recurrent TS and related morbidity. Registration ClinicalTrials.gov NCT04325321
Salmoirago‐Blotcher et al. (2026) studied this question. Hair cortisol concentration in patients with Takotsubo syndrome was twice as high as in clinically stable controls (7.3 vs. 3.5 pg/mg, p < .01), indicating increased chronic stress.