Role of hypercortisolemia in the comorbid course of coronary artery disease, diabetes mellitus type 2 and anemia

Abstract

The results of the investigation are components of the scientific-research work “Features of the comorbid course of the diseases of internal organs: risk factors, mechanisms of the progression and comorbidity, pharmacotherapy”. №0114U002475. The aim of the study – investigation of dynamics of cortisol synthesis changes in patients of older age groups with coronary artery disease (CAD) with comorbid diabetes mellitus type 2 (DM) and anemic syndrome (AS). Material and methods. Blood cortisol level was measured in 40 old and senile CAD patients with comorbid DM and AS of different degrees of severity. Control group consisted of 12 patients with CAD without comorbidities that were not significantly different by gender and age from patients of research groups. Possible effects of telmisartan on the degree of chronic hypoxia were also investigated. Results. In patients of old and senile age with CAD and comorbid AS, same as in case of CAD and AS on the background of DM, activation of the cortisol synthesis is observed, likely in response to hypoxia as a stress factor in anemia. The degree of severity of the detected changes was different depending on the degree of anemia severity. There was no normalization of cortisol content in blood in any of the major experimental groups regardless the prescribed treatment with ACE inhibitors or telmisartan. Conclusion. In patients with CAD, same in the case of a comorbid course of CAD and DM, an increase of cortisol secretion in response to anemic hypoxia was observed. As the degree of severity of the AS progressed, gradual decreasing of cortisol blood level was detected. Reduction of the intensity of stress-limiting systems in the organism by telmisartan prescription may help to eliminate the adverse effects of hypercortisolemia on the progression of coronary artery disease, especially on the background of comorbid diabetes mellitus type 2 and anemia.