Attenuated cortisol response to a standardized stress test in Lithuanian versus Swedish men: The LiVicordia study

Cardiovascular mortality rates of middle-aged men are 4 times higher in Lithuania than in Sweden. The difference is not explained by standard risk factors, but our previous findings of pronounced psychosocial stress in Lithuanian men offer a possible explanation. We investigated cortisol and cardiovascular reactivity to a standardized laboratory stress test in population-based random samples of 50-year-old men from Vilnius, Lithuania and Linkoping, Sweden. Repeated measures analysis of variance showed that cortisol responses differed between cities (p's <.0001). Mean change of serum cortisol from baseline to 30 min was 18.1 and 88.4 nmol/l for Vilnius and Linkoping men, respectively (p <.001). In a multivariate analysis, a low peak cortisol response was significantly related to high baseline cortisol, current smoking, and vital exhaustion. The findings suggest a physiological mechanism of chronic psychosocial stress, which may contribute to increased risk for cardiovascular death.