Evaluation of stress response in diabetic hypertensive patients

In this research, we aimed to examine salivary cortisol changes in the cognitive stress response of patients with Hypertension + Diabetes Mellitus (HT+DM) and Hypertension (HT) and to determine the differences between them. 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. There was no statistically significant difference among HT+DM and HT groups on blood pressure (BP) values (p>.05). The HT+DM group finds to have higher fasting glucose and lower LDL and total cholesterol values compared to HT group (p<.05). When measured by repeated ANOVA, salivary cortisol level [F (1.842, 60) = 8.771, p<.0001], systolic blood pressure [F (2.185, 60) = 12.080, p<.ooo1], diastolic blood pressure [F (2.793, 60) = 6.043, p=.001] and the heart rate [F (2.073, 60) = 13.259, p<.0001] were statistically significant for the main effect (time), while the effect of the group*time interaction factor was statistically not significant (p>.05). In conclusion, the arithmetic problem-solving task used in the HT+DM and HT patients was found to be useful as an acute stress test in the laboratory environment. In the HT+DM and HT groups, salivary cortisol and BP values increased significantly after acute stress, but no statistically significant difference was found in terms of group*time interaction factor. Cognitive stress related salivary cortisol reactivity was found to be affected by different antihypertensive drugs. Key Words: Hypertension, Diabetes Mellitus, Salivary Cortisol, Stress, Aldosterone.