Evaluation of Exercise Time and Cardiac Autonomic Responses with an Exercise Stress Test in Primary Adrenal Insufficiency

Objective: The aim was to evaluate autonomic dysfunction by investigating exercise time, the chronotropic index (CI), and heart rate recovery (HRR) during an exercise stress test (EST) in patients with primary adrenal insufficiency, also called Addison's disease (AD). Methods: Twenty-two patients with adrenal insufficiency and 25 healthy controls were included in this study. The data from the patients who underwent an EST were collected, analyzed, and reported. Results: The mean ages and genders of the patients with AD and the controls were insignificant. The baseline systolic and diastolic blood pressures (SBP and DBP) were significantly lower in the patients with AD compared to the controls before the EST. According to exercise -induced data, the SBP, DBP, and CI were insignificant for females and males between the groups. The exercise time, HRR1, and HRR2 were significantly decreased in the patients with AD compared to the controls. When the patients and controls were evaluated by gender, other than the HRR1 of the females, there were no differences between both genders. Additionally, a multiple logistic regression analysis showed that exercise time was independent and negatively related to the CI, HRR1, and HRR2 in the patients with AD. Conclusion: Exercise time and cardiac autonomic dysfunction in patients with AD may be related to mortality and morbidity. However, further studies and detailed analyses are needed on this subject.