BDNF and alcohol abuse: Indeed, we have confirmed that chronic depression in the SABPA African teachers’ cohort was associated with microvascular dysregulation and perfusion deficits.21 If this state is further supported by high levels of alcohol abuse, the central depressant effect of alcohol may disturb central cardiometabolic homeostasis.21 Chronic psychological stress induces sympathetic hyperactivity,17 higher circulating levels of catecholamine and cortisol, and ultimately down-regulation will occur.12,22-24 Therefore, the lower cortisol level may act as the driving force behind a possible down-regulated BDNF.