One of the most common comorbid condition in people over 40 years old is: arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD). The frequency of AH in patients with COPD varies from 6.8 to 76.3%, in average 34.3%. COPD is detected in every fourth patient with hypertension in the age group of 2564 years. The current trend towards an increase in life expectancy and therefore growing pool of elder cohort, will lead to a higher number of patients with comorbid disorders. Diagnosis and treatment of AH and COPD are determined by current clinical recommendations for both nosologies, however, a number of mutual pathophysiological mechanisms lead to a more severe course of these diseases with frequent exacerbations. The choice of antihypertensive therapy in patients with AH in combination with COPD should be given to drugs that can provide an adequate decrease in blood pressure in hypoxic conditions, especially at night and early morning hours, that have prolonged effect or could be prescribed in the evening, and to those that dont worsen bronchial obstruction or exacerbate hypoxia. Patients with AH and COPD should be given recommendations on lifestyle changes, especially smoking cessation. As initial therapy calcium channel blockers, angiotensin receptor blockers or angiotensin-converting enzyme inhibitors should be considered. Calcium channel blockers/renin-angiotensin system blockers should be considered as the first line for combination therapy. Thiazide, thiazide-like diuretics orb1-selective adrenergic blockers could be prescribed in case of insufficient antihypertensive response or depending on different clinical scenarios. Bronchodilators are the baseline therapy in COPD with concomitant AH. According to modern concepts, prescription of combination therapy with different mechanisms of action is the most proven and justified approach, which leads to a decrease in the frequency of exacerbations of COPD and amelioration of the symptoms. The choice of bronchodilator in the case of a COPD and AH combination, should take into account the proven long-term safety regarding the risk of cardiovascular complications. Tiotropium bromide as the monotherapy, including as a liquid inhaler and aclidinium/formoterol, tiotropium/oladeterol as combination therapy showed cardiovascular safety in the long-term studies. The escalation of COPD therapy with the need of inhaled steroids requires careful monitoring of blood pressure and, possibly, a revision of antihypertensive treatment leading to its escalation as well. COPD has many phenotypes requiring different medications, eg.: roflumilast, theophylline, macrolides and mucoactive drugs, that could also require tighter blood pressure control on patients with COPD and AH.

Aim. To compare the effect of cardiovascular risk factors on aortic stiffness in people of European and East Asian ethnic groups.Material and methods. A total of 266 patients aged 18-60 years of European (n=133) and Korean (n=133) ethnic groups were examined. Clinical assessment was carried, Also, following blood parameters was evaluated: total cholesterol (TC), low- (LDL-C) and high- (HDL-C) density lipoprotein cholesterol, apolipoproteins A (apo-A) and B (apo-B), triglycerides (TG), uric acid, creatinine, glucose, adiponectin, resistin. The aortic pulse wave velocity (PWV) and central blood pressure (CBP) were determined using a Tensiomed arteriograph (Hungary). The study design included 3 stages. The first stage included statistical analysis using Mann-Whitney, χ2, Fisher tests, while the second one — determination of weighing coefficients of individual risk factors on aortic PWV. The third stage consists of verification of the relationship between ethnicity and aortic PWV using multivariate logistic regression and stochastic gradient boosting (SGB).Results. In Europeans, the median values of growth, body mass index (BMI), waist circumference (WC) and waist-to-height ratio were significantly higher, while the levels of apo-B, TC, HDL-C, LDL-C, TG was significantly lower than in Asians. Koreans had higher blood concentrations of UA, creatinine, glucose, while the resistin concentration was 1,8 times lower. Among Europeans, the odds ratio of developing hypertension (HTN) was significantly higher. The level of aortic PWV in people of different ethnic groups did not differ significantly. Univariate logistic regression showed a dominant influence of age, CPP and waist-to-height ratio on aortic PWV. A less noticeable significant relationship with aortic PWV had HTN, female sex, BMI, levels of systolic, diastolic and pulse BP. Multivariate logistic regression and SGB showed the maximum prediction accuracy when 5 predictors were combined in one model: age, height, HTN, LDL-C, and ethnicity. Comparable accuracy was demonstrated by a model where glucose level was used instead of LDL-C. The results indicate a nonlinear relationship between the ethnic factor and aortic PWV. Its predictive potential was realized only in combination with functional and metabolic status parameters of patients. In Koreans, the threshold values of these factors can be significantly higher than in Europeans.Conclusion. Developed using modern machine learning technologies, the assessment aortic PWV models taking into account the ethnic factor can be a useful tool for processing and analyzing data in predictive studies.

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