Serum cortisol-to-cortisone ratio and 11-deoxycortisol are associated with hypertension and blood pressure in Chinese rural population: a cross sectional study.

Objective: The present study aimed to investigate the associations of cortisol-to-cortisone ratio (F/E) and 11-deoxycortisol (S) in hypertension and blood pressure among Chinese rural population.
Methods: A total of 6233 participants from the Henan Rural Cohort Study were included. Serum cortisol (F), cortisone (E), and S were assessed using liquid chromatography-tandem mass spectrometry. Generalized linear model (GLM) and logistic regression model were performed to assess the associations of F, E, F/E, and S with blood pressure and hypertension. Moreover, the sex specificity of the associations was assessed.
Results: Serum F, F/E, and S were positively associated with systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP), while E was negatively associated with SBP and PP. There were no statistically significant associations of F and E with the prevalence of hypertension, while F/E and S were positively associated with hypertension [odds ratios (ORs) and 95% confidence intervals (CIs)] of F/E and S were 1.28 (1.13, 1.44) and 1.10 (1.04, 1.17), respectively. Also, the combination of high F/E and S was significantly associated with hypertension. The blood pressure indicators and the prevalence of hypertension increased with an incremental in the serum concentration of F, F/E, and S (all Ptrend < 0.05). In addition, the positive association between F/E and SBP was stronger in women than that in men, and F/E was strongly positively associated with hypertension only in women (all Pinteraction < 0.05).
Conclusion: Serum F/E and S were positively associated with hypertension and blood pressure. Additionally, their combination has a synergistic effect on hypertension. Moreover, the associations of F and F/E with hypertension and blood pressure were in a sex-specific manner.
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