Dynamics of cortisol indicators in patients with mild arterial hypertension I-II stages in the conditions of a stress test against the background of excessive anxiety and hyperventilation syndrome

Annotation. The aim of the study was to investigate the dynamics of cortisol levels in 105 patients with mild (grade 1) arterial hypertension (AH) of stage I-II (st.) against the hyperventilation syndrome (HVS) and excessive anxiety, in the conditions of a 6-minute walk test (6MWT). The control group of patients included 28 patients with mild hypertension, I-II stages, without signs of vegetosomatic disorders. The state of anxiety and HVS was determined by the Spielberger-Hanin scale and the Nijmegen questionnaire. The level of cortisol in saliva was determined by enzyme-linked immunosorbent assay method on the “Stat Fax 303 Plus” analyzer. Statistical analysis was performed using the Statistica v.10 program (USA). It was found that normal baseline cortisol levels in patients of the main group with AH I stage were found in 36.96% of patients and amounted to 5.63±0.33 nmol/l, in AH II stage - in 41.46% of patients. The conditional norm was the result obtained in the group of practically healthy individuals. In the control group with I-II stage of hypertension, normal baseline values were observed in 65.5% and 58.33% of patients, respectively. Increased baseline cortisol levels (6.58±0.32) nmol/l were detected in 47.83% of patients in the main group with AH I stage, and in 46.34% of patients with AH II stage (6.72±0.26) nmol/l (p˂0.05); in the control group, respectively, in 37.5% and 41.67% of patients. The rest of the patients, reduced baseline cortisol levels were found. After 6 MWT, in the main group with stage I hypertension, the number of cases with elevated cortisol levels increased by 8.70%, and the number of patients with low levels decreased by 10.87%. In stage II hypertension, after 6 MWT, the number of patients with elevated cortisol levels increased by 12.20%, while the number of cases with low levels decreased by 7.32% and the number of normal levels decreased by 4.88%. In the control group with stage I hypertension after 6 MWT, a decrease in normal cortisol levels was noted in 6.25% of patients and a similar increase in the number of patients with elevated levels. In stage II hypertension after 6 MWT, cases with normal cortisol levels decreased by 16.33%; at the same time, the number of patients with elevated levels increased by 8.33%. The dynamics of cortisol levels after exercise in mild hypertension with excessive anxiety and hypertension indicates the tension of neuroendocrine regulation mechanisms, the risk of destabilization of the underlying disease under stress.