Psychoemothional factors and 24-hour blood pressure profile in men with hypertension

Objective: to perform comprehensive analysis of serum cortisol levels and 24-hour blood pressure profile in male patients with arterial hypertension with or without obesity, and to investigate relationship of blood pressure profile with psychological stress and anxiety levels. Materials and methods: the study included 76 hypertensive male patients (mean age 46.7 ± 0.5 years). Group 1 included 36 hypertensive men with obesity, group 2 — 40 hypertensive men without obesity. Сontrol group included 26 practically healthy men, comparable in age with groups 1 and 2 (mean age 42.58 ± 1.45 years). All patients underwent 24-hour blood pressure monitoring. Serum cortisol levels was assessed by enzyme immunoassay using Cortisol-IFA-BEST reagent kit. The level of psychological stress was determined by PSM-25 scale. The level of reactive and personal anxiety was determined by Spielberger-Khanin questionnaire. Results: there was a significant increase in average 24-hour, daytime and nighttime blood pressure values, its variability and decline in the nocturnal blood pressure fall (p < 0.05). The highest level of cortisol — 890.2 ± 56.7 nmol / l was detected in group 1 (p < 0.05 compared to group 2 and control group). Correlation analysis revealed significant relationships of blood pressure variability and nocturnal blood pressure fall with the level of anxiety and psychological stress, as well as with cortisol blood levels. Conclusion: the presence of increased anxiety and psychological stress in patients with hypertension is associated with decline in the nocturnal blood pressure fall and increase in its 24-hour variability, to a greater extent when hypertension is accompanied by obesity.