Evaluation of Stress Response in Middle Age Male Diabetic Hypertensive Patients

J Clin Endocrinol Metab. 2023 Mar 6;dgad122. doi: 10.1210/clinem/dgad122. Online ahead of print.


Background: Stress triggers a cascade of reactions that alter the organism's dynamic steady state. There is a scarcity of interventional studies that show cortisol variability on stress over time in groups of patients with chronic noncommunicable diseases and comorbidities.

Purpose: In this research, we aimed to examine salivary cortisol changes in the cognitive stress response of patients with Hypertension and Diabetes Mellitus (HT & DM) and patients with Hypertension (HT) and to determine the differences between them.

Methods: The research was conducted by solving an arithmetic task as a stress test in 62 patients with HT&DM and HT that are being treated in the outpatient clinic of Medical Pharmacology and Clinical Pharmacology Department in Istanbul University, Istanbul Medical Faculty Hospital.

Results: There was no statistically significant difference among HT&DM and HT groups on systolic and diastolic blood pressure (BP) values (p = 0.331 and p = 0.058). When measured by repeated ANOVA, salivary cortisol level [F (1.842, 60) = 8.771, p < 0.0001], systolic blood pressure [F (2.185, 60) = 12.080, p < 0.0001], diastolic blood pressure [F (2.793, 60) = 6.043, p = 0.001] and the heart rate [F (2.073, 60) = 13.259, p < 0.0001] were statistically significant for the main effect (time), while the effect of the group*time interaction factor was statistically not significant (p = 0.773; p = 0.751; p = 0.713 and p = 0.506, respectively).

Main conclusions: In conclusion, the arithmetic problem-solving task used in the HT&DM and HT patients were found to be useful as an acute stress test in the laboratory environment. There was no statistically significant difference was found in terms of group*time interaction factor between the HT&DM and HT groups, however the salivary cortisol and BP values increased significantly after acute stress within each group.

Keywords: Diabetes Mellitus; Hypertension; Salivary Cortisol; Stress test.