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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 at Istanbul University, Istanbul Medical Faculty Hospital.
In this study, saliva samples were taken for cortisol measurement, and patients were instructed to place the cotton piece in the salivette® tubes directly into their mouths without touching it with anything, hold it for 30-60 seconds, and then insert it back into the tubes in the same way, four times total, once before arithmetic stress and three times after stress, on Tuesdays, Wednesdays, and Thursdays between the hours of 12:00-16:00.
Salivary cortisol was measured using the electro-chemiluminescence immunoassay.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hypertension + Diabetes Mellitus (HT+DM) | Patients who fulfilled the following criteria were included in this group:
|
| |
| Hypertension (HT) | Patients who fulfilled the following criteria were included in this group:
|
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| First arithmetic problem solving | Behavioral | In a quiet environment, a white paper in A4 format was placed in front of the patient on the table, and the patients were asked to subtract the number 3 from 2907 for 100 seconds. The researcher was standing in front of the patient and asks to make corrections by giving a warning whenever the patient made a mistake in the calculation. |
| Measure | Description | Time Frame |
|---|---|---|
| Cortisol | A saliva sample is collected for cortisol evaluation | Baseline |
| Cortisol | A saliva sample is collected | 30 minutes after beginning |
| Cortisol | A saliva sample is collected | 45 minutes after beginning |
| Cortisol | A saliva sample is collected | 60 minutes after beginning |
| Blood pressure | The patient is rested by sitting before the measurement | Baseline |
| Blood pressure | The patient is rested by sitting before the measurement | 15 minutes after beginning measurement |
| Blood pressure | The patient is rested by sitting before the measurement | 35 minutes after beginning measurement |
| Blood pressure | The patient is rested by sitting before the measurement | 50 minutes after beginning measurement |
| Blood pressure |
| Measure | Description | Time Frame |
|---|---|---|
| Mental state examination | Mini Mental State Examination - MMSE is used to evaluate the mental state | Baseline |
| Physical activity | International Physical Activity Questionnaire is used to evaluate the level of physical activity |
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Inclusion Criteria:
Exclusion Criteria:
All participants were male based on self-representation of gender identity.
The study population consisted of patients in the register of the pharmacology clinic of the faculty of medicine who have a diagnosis of hypertension and diabetes mellitus type 2.
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| Name | Affiliation | Role |
|---|---|---|
| Iliriana Alloqi Tahirbegolli, Prof.Ass.Dr. | Istanbul University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul University | Istanbul | 34000 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36880261 | Derived | Alloqi Tahirbegolli I, Tahirbegolli B, Sen S, Sayin B, Kaskal M, Uresin AY. Evaluation of Stress Response in Middle-Aged Male Diabetic Hypertensive Patients. J Clin Endocrinol Metab. 2023 Aug 18;108(9):2307-2314. doi: 10.1210/clinem/dgad122. |
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Based on the regulations it is not mandatory for this study to share the individual data of patients. But in the case of a proper request by researchers the data can be shared by the principal researcher of the study.
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| Second arithmetic problem solving | Behavioral | In the same A4-sized white paper that was placed in front of each patient on a table, immediately after the first subtraction process, patients were asked to subtract 7 from 6828 for another 100 seconds. When the patient made a calculating error, the researcher stood in front of the patient and asked them to make corrections by issuing a warning. |
|
| Third arithmetic problem solving | Behavioral | In the same A4-sized white paper that was placed in front of each patient on a table, immediately after the previous subtraction process, patients were asked to subtract 13 from 9561 for another 100 seconds. When the patient made a calculating error, the researcher stood in front of the patient and asked them to make corrections by issuing a warning. |
|
| Fourth arithmetic problem solving | Behavioral | In the same A4-sized white paper that was placed in front of each patient on a table, immediately after the previous subtraction process, patients were asked to subtract 8 from 5113 for another 100 seconds. When the patient made a calculating error, the researcher stood in front of the patient and asked them to make corrections by issuing a warning. |
|
| Fifth arithmetic problem solving | Behavioral | In the same A4-sized white paper that was placed in front of each patient on a table, immediately after the previous subtraction process, patients were asked to subtract 14 from 8318 for another 100 seconds. When the patient made a calculating error, the researcher stood in front of the patient and asked them to make corrections by issuing a warning. |
|
| Sixth arithmetic problem solving | Behavioral | In the same A4-sized white paper that was placed in front of each patient on a table, immediately after the previous subtraction process, patients were asked to subtract 17 from 9994 for another 100 seconds. When the patient made a calculating error, the researcher stood in front of the patient and asked them to make corrections by issuing a warning. |
|
The patient is rested by sitting before the measurement
| 75 minutes after beginning measurement |
| Aldosterone | Venous blood sample is collected | Baseline |
| Heart Rate | The patient is rested by sitting before the measurement | Beginning |
| Heart Rate | The patient is rested by sitting before the measurement | 15 minutes after beginning |
| Heart Rate | The patient is rested by sitting before the measurement | 35 minutes after beginning |
| Heart Rate | The patient is rested by sitting before the measurement | 50 minutes after beginning |
| Heart Rate | The patient is rested by sitting before the measurement | 75 minutes after beginning |
| Baseline |
| Health related Quality of life | SF-36 v2 is used to evaluate the health related quality of life | Baseline |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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