Cortisol on Circadian Rhythm and Its Effect on Cardiovascular System

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 11 beta-hydroxysteroid dehydrogenase (11 beta-HSD1), which is a novel molecular target of interest for treating metabolic syndrome and type-2 diabetes mellitus. 11 beta-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.

Automated summary

Cortisol synthesis and secretion are regulated by the hypothalamic-pituitary-adrenal axis, exhibiting a 24-hour circadian rhythm that influences the cardiovascular system and other physiological functions. 11 beta-hydroxysteroid dehydrogenase (11 beta-HSD1) is a novel target for treating metabolic syndrome and type-2 diabetes, with inhibition alleviating metabolic abnormalities. This review emphasizes the role of cortisol in controlling circadian rhythm and its impact on the cardiovascular system, providing insights for potential cardioprotective therapeutic agents in the future.