Dynamics of antioxidant protection indicators under the influence of graded exercise against the background of changes in cortisol levels in patients with arterial hypertension

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Background. Arterial hypertension (AH) remains a lea­ding risk factor for the development of cardiovascular complications. Chronic stress and alterations in neuroendocrine regulation, particularly in the activity of the hypothalamic-pituitary-adrenal axis, play a key role in the pathogenesis of AH. Physical exertion is a stressor that activates hormonal response and influences the oxidative-antioxidant status of the body. The purpose was to compare the effect of standardized bicycle ergometry on cortisol levels, antioxidant enzyme activity, and the concentration of gasotransmitters (hydrogen sulfide and nitric oxide) in healthy individuals and patients with stage II AH. Materials and methods. The study included 10 practically healthy individuals and 30 patients with stage II AH. Participants performed two-stage exertion on a bicycle ergometer. Serum cortisol levels (enzyme-linked immunosorbent assay), cata­lase and superoxide dismutase activity, plasma hydrogen sulfide concentration, and the sum of nitrates/nitrites were determined. Statistical analysis was performed using IBM SPSS Statistics 25.0. Results. Multidirectional cortisol dynamics was revealed: levels increased by 20.3 % in healthy individuals, while a decrease of 2.2 % was noted in AH patients (p < 0.05). In the control group, catalase activity and the sum of nitrates/nitrites significantly decreased after exertion. In AH patients, these changes were less pronounced; however, baseline nitrate-nitrite-anion levels were significantly higher. Direct correlations were found between cortisol and hydrogen sulfide levels after exertion (r = 0.72 in the healthy group). Two-stage graded exercise caused the opposite dynamics of cortisol levels: in healthy individuals, cortisol increased (corresponding activation of the hypothalamic-pituitary-adrenal axis), and in AH patients, it decreased. Antioxidant enzymes showed different reactions: in the control group, the activity of catalase and superoxide dismutase significantly decreased after exertion, while in AH patients, these changes were insignificant. Conclusions. The observed direct correlations between cortisol and hydrogen sulfide levels (especially in healthy subjects after exertion) emphasize the role of hydrogen sulfide as a mediator of stress response and a regulator of vascular tone. The data indicate that adaptive mechanisms to physiological stress are shifted in AH, with endogenous hydrogen sulfide being important. Graded exercise causes adequate activation of the stress system in healthy individuals and a suppressed response in AH patients.

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