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[The effect of verapamil on adrenocortical hormone secretion]
1Abteilung Endokrinologie/Stoffwechselerkrankungen, Bereiches Medizin der Karl-Marx-Universität Leipzig.
Insights
Verapamil affects cortisol levels differently based on ACTH stimulation. Low-dose ACTH tests show decreased cortisol, while high-dose tests reveal increased cortisol in cardiovascular patients.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
Context:
- Circadian cortisol rhythm and ACTH secretion are crucial endocrine functions.
- Cardiovascular diseases may impact these hormonal rhythms.
- Verapamil is a medication used for cardiovascular conditions.
Purpose:
- To investigate the effects of verapamil on the hypothalamic-pituitary-adrenal (HPA) axis in cardiovascular patients.
- To compare hormonal responses in healthy volunteers and patients under basal and stimulated conditions.
Summary:
- Basal cortisol and ACTH levels did not differ significantly between healthy subjects and cardiovascular patients.
- Both groups showed similar cortisol and ACTH increases during low-dose (ACTHL-test) and high-dose (ACTHH-test) ACTH stimulation before verapamil.
- After verapamil administration, the ACTHL-test resulted in decreased plasma cortisol, whereas the ACTHH-test showed a significant increase in plasma cortisol.
Impact:
- Verapamil influences HPA axis response to ACTH stimulation in cardiovascular patients.
- This suggests verapamil may modulate cortisol release differently under varying stress levels.
- Findings have implications for managing cardiovascular patients with potential HPA axis dysregulation.
Abstract:
Variations in circadian cortisol rhythm, morning ACTH concentration and the 24-hour cortisol excretion were examined in 15 healthy volunteers and 9 untreated patients with cardiovascular diseases. These variations were measured under basal conditions and during low dose (ACTHL-test) and also a high dose (ACTHH-test) ACTH stimulation. Additionally, in the patients with cardiovascular diseases the effect of verapamil-administration was investigated. Under basal conditions no significant differences were to be seen between normal subjects and the patients, either before or after therapy. The two functional tests resulted in almost identical increases of cortisol and ACTH levels, both in healthy subjects and the patients before verapamil. It was found that after verapamil application during the ACTHL-test, the levels of plasma cortisol decreased in comparison with the values noted before verapamil (p less than 0.05). However, in the ACTHH-test a significant increase of the plasma cortisol (p less than 0.05) was evident. Our results lead to the conclusion that after verapamil therapy, under slight loading, the plasma cortisol concentration can be expected to decrease slightly, and in extremely high stress situations it will increase.