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Hormonal supply during physical exercise in elderly patients with ischemic heart disease
O V Korkushko1, M V Frolkis, Y T Yaroshenko
1Institute of Gerontology AMS USSR, Kiev.
Insights
Elderly patients with ischemic heart disease (IHD) show altered hormonal responses to physical stress. Inadequate increases in adrenocorticotropic hormone (ACTH) and cortisol levels worsen IHD and reduce exercise tolerance.
Area of Science:
- Endocrinology
- Cardiology
- Geriatrics
Background:
- Ischemic heart disease (IHD) and stable exertional angina pectoris affect elderly individuals.
- Hormonal responses, including adrenocorticotropic hormone (ACTH), cortisol, and met-enkephalins, may be altered in IHD patients.
Purpose of the Study:
- To investigate the relationship between hemodynamic and pituitary-adrenal system responses during physical exercise in elderly IHD patients.
- To determine the impact of physical stress on hormonal levels and exercise tolerance in this population.
Main Methods:
- Study included 30 elderly males with IHD and stable exertional angina, and 15 age-matched healthy volunteers.
- Basal hormonal levels (ACTH, cortisol, met-enkephalins) were measured.
- Hormonal and hemodynamic responses to graded physical exercise were assessed, with some patients receiving propranolol.
Main Results:
- IHD patients exhibited elevated basal ACTH, cortisol, and met-enkephalins compared to controls.
- Two distinct hormonal response patterns to exercise were observed in IHD patients: one with rising ACTH/cortisol, another with declining levels.
- Patients with rising ACTH/cortisol showed less economical hemodynamic responses and reduced exercise tolerance.
- Propranolol modulated hormonal responses to physical stress.
Conclusions:
- An inadequate increase in ACTH and cortisol during stress contributes to IHD aggravation and decreased exercise tolerance in the elderly.
- The interplay between the pituitary-adrenal system and hemodynamic function is crucial in elderly IHD patients undergoing physical exertion.
- Beta-blockers like propranolol can influence these hormonal responses during physical stress.
Abstract:
30 males, suffering from ischemic heart disease (IHD), and stable exertional angina pectoris, whose age ranged from 60 to 74 years and also 15 apparently healthy volunteers of the same age participated in the study. The IHD patients' blood displayed increased basal levels of adrenocorticotropic hormone (ACTH), cortisol, and met-enkephalins. During graded physical exercise two types of hormonal system response were established: in the first group of patients the plasma ACTH and cortisol levels were seen to rise at maximal threshold load, while in the second group the content of the above hormones declined. The first group of patients showed a less economical hemodynamic response to standard loading in comparison to the second group. A relation was found between changes in hemodynamic system and function of pituitary-adrenal system in elderly IHD patients during physical exercise. Inadequate ACTH and cortisol increase in the course of effects of stress contributed to IHD aggravation in old age, along with reduced tolerance to physical exercise. beta-Adrenoblocker, propranolol, influenced both types of hormonal response, thereby diminishing their shifts in physical stress.