• Christiaan E Schutte, Leoné Malan, Jacobus D Scheepers, Woudri Oosthuizen, Marike Cockeran, and Nicolaas T Malan.
• Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa.
• Cardiovasc J Afr. 2016 Nov 1; 27 (6): 387-391.

AimEmotional distress has been associated with cardiovascular disease (CVD) in Africans. Cortisol and brain-derived neurotrophic factor (BDNF), as markers of emotional distress, increase cardiometabolic risk. We therefore aimed to investigate associations between cardiometabolic risk markers and the cortisol-to-BDNF ratio (cortisol:BDNF).MethodsA cross-sectional study included a bi-ethnic gender cohort (n = 406) aged 44.7 ± 9.52 years. Ambulatory blood pressure (ABPM), ECG, fasting serum cortisol and BDNF levels and cardiometabolic risk markers were obtained.ResultsAfricans had increased incidence of hyperglycaemia and 24-hour silent ischaemic events, and elevated 24-hour blood pressure (BP) and cortisol:BDNF ratios compared to Caucasians. Forward stepwise linear regression analysis underscored a similar trend with associations between hyperglycaemia, 24-hour BP [Adj R2 0.21-0.29; β 0.23 (0.1-0.4); p = 0.01], silent ischaemia [Adj R2 0.22; β 0.40 (0.2-0.6); p < 0.01] and cortisol:BDNF levels in Africans, mostly in the men.ConclusionAttenuated cortisol levels in this group may be indicative of emotional distress and if chronic, drive the cortisol:BDNF ratio to desensitise BDNF. Desensitised cortisol:BDNF may sustain cardiometabolic risk and induce neurodegeneration in African men via silent ischaemia. Compensatory increases in blood pressure to increase perfusion and maintain homeostasis may increase coronary artery disease risk.

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