Aim: to compare the antianginal and pulse slowing effects, the impact on the ectopic myocardial activity as well as the safety of the treatment with beta - adrenoblocker bisoprolol, calcium antagonist verapamil and the combination of bisoprolol with amlodipine in patients with stable angina (SA) and bronchial asthma (BA). Materials and methods. The study included 90 patients with SA II-III functional class (FC) having concomitant persistent asthma of moderate severity, controlled, without exacerbation. The patients were divided into three groups with 30 individuals in each one depending on the main antianginal drug prescribed. Group 1 patients received a cardio - selective beta - adrenergic blocker bisoprolol (Concor) at the dose of 5 mg/day, patients of group 2 were treated by a calcium antagonist verapamil at the dose of 240 mg/day, patients of group 3 received combined therapy with bisoprolol at the dose of 5 mg/day and amlodipine at the dose of 5 mg/day given as a fixed combination (Concor AM 5/5). All the patients were investigated by the methods of daily ECG monitoring and respiratory function study (RFS) in addition to physical examination at baseline and after 4 weeks of treatment. Results. After 4 weeks of treatment, patients of group 1 and group 3 did not complain of angina attacks and did not use nitroglycerin unlike patients of group 2. The achieved heart rate (HR) in group 1 patients was 68.6±8.5 beats/min, in group 2 - 74.3±5.6 beats/min, in group 3 - 67.3±4.8 beats/min. A significant decrease in the number of supraventricular and ventricular extrasystoles occurred in patients of group 1 and group 3 only. Thus, the pulse slowing, antianginal, antiischemic and antiarrhythmic effect of the calcium antagonist verapamil, even at the dose of 240 mg/day, is not always sufficient for the patients with SA II-III FC and concomitant BA, unlike therapy with the inclusion of beta - blocker bisoprolol. During the study there was no registered deterioration in the indices of bronchial patency according to the RFS data in the patients of all three groups. Conclusion. In patients with coronary artery disease and concomitant asthma, all three types of pulse slowing therapy do not have any negative effects on bronchial patency. Therapy with the inclusion of beta - blockers (bisoprolol or its combination with amlodipine), in contrast to verapamil, reliably reduces heart rate and the number of supraventricular and ventricular extrasystoles in addition to a good antianginal effect.

The research purpose: to study features of clinical process of a coronary heart disease when it combines with a bronchial asthma.The materials and methods: 180 people were included in the research, 90 of them suffer from both CHD and BA (the first group), and also 90 people have only CHD without BA (the second group). The examination included complaint collection process, studying medical history, medical examination, percussion, auscultation, blood pressure measurement with the Korotkov’s method twice a day (in the morning and in the evening), heart rate measurement, 24-hour Holter ECG monitoring, echodoplercardiography. Besides, standard laboratory biochemical testing, including total cholesterol and lowdensity lipoprotein cholesterol, were made with the enzymatic colorimetric method.The results. Dyspnoea is the main complaint among 86 patients with both CHD and asthma, humans have (95,5%), moreover, dyspnoea combines with heartbeating in 73,8%, and is accompanied by angina pectoris only in 20%. There is a significant difference between systolic and diastolic blood pressure (р=0,001) that becomes higher if CHD combines with asthma. The signs of left ventricular and interventricular septum hypertrophy were discovered in the first group, these signs statistically significantly differ from the ones in the second group. The medium pulmonary arterial pressure is significantly higher in the combined group than in the group with only CHD (р=0,001). It is revealed with 24-hour Holter ECG monitoring that cases of myocardial ischemia are more frequent in the group which consists of patients with CHD. Besides, duration of ischemic depression per day is longer in this group too. It might be that if patients have both CHD and asthma they do not reach an ischemic threshold because of dyspnoea due to a respiratory failure.The conclusion. According to our findings bronchial asthma occurs among patients with coronary heart disease in 16.6% of cases. It is a distinctive feature of a bronchial asthma associated with coronary heart disease, that a patient often complaints to dyspnea (cardiopulmonary) and palpitation, increase in arterial blood pressure and heart rate, which appropriately indicates the activation of rennin-angiotensin-aldosteron and sympathicoadrenal systems. It requires the inclusion of appropriate drug groups in the treatment of patients.