Carpenter, Janet S.Tisdale, James E.Larson, Joseph C.Sheng, YingChen, Chen X.Von Ah, DianeKovacs, RichardReed, Susan D.Thurston, Rebecca C.Guthrie, Katherine A.2023-09-262023-09-262021-11-29Carpenter JS, Tisdale JE, Larson JC, et al. MsFLASH analysis of diurnal salivary cortisol and palpitations in peri- and postmenopausal women. Menopause. 2021;29(2):144-150. Published 2021 Nov 29. doi:10.1097/GME.0000000000001897https://hdl.handle.net/1805/35792Objective: To evaluate the relationship between diurnal salivary cortisol patterns and distress from heart palpitations in midlife women. Methods: We analyzed baseline data from 293 women who were eligible for a 3 × 2 factorial trial of exercise or yoga versus routine activity, and omega-3 fish oil versus placebo for vasomotor symptoms. Women self-collected salivary cortisol using swabs at four time points over 2 consecutive days and reported distress from heart racing or pounding during the past 2 weeks using a single item. Sample description and covariate data included demographics, clinical data, vasomotor symptom frequency from daily diaries, medication use, and validated questionnaires on depression, stress, and insomnia (Patient Health Questionnaire-8, Perceived Stress Scale, and Insomnia Severity index). Data were analyzed using descriptive statistics, chi-square and t tests, and repeated measure linear regression models. Results: Participants were on average 54.6 (SD = 3.6) years old, most were White (67%) postmenopausal (84%), and 26% reported distress related to palpitations. In adjusted models, the morning (wake plus 30-min) geometric mean daily salivary cortisol concentrations were significantly more blunted in those with distress from palpitations compared with those without distress (P ≤ 0.03). When all covariates were controlled, distress from palpitations was the sole significant predictor of wake plus 30-minute cortisol (-0.25 [-0.45 to -0.04], P = 0.02). Conclusions: Palpitations among midlife women may be associated with blunted morning cortisol, and this relationship is not explained by demographics, clinical variables, vasomotor symptoms, medications, depression, stress, or insomnia.en-USPublisher PolicyCortisolMenopausePalpitationsHormoneBiomarkerArticle