Arterial hypertension and chronic obstructive pulmonary disease: clinical characteristics and treatment efficasy (according to the national register of arterial hypertension)

Abstract

Arterial hypertension (AH) is one of the major factors, causing high level of population mortality in many countries, including Russia. Natural aging of population in the beginning of 20th century leads to medical and social issues; and frequent comorbidity is one of them. The occurrences of chronic obstructive pulmonary disease (COPD) are rather often among the population, especially among city dwellers and males. AH and COPD are frequent comorbid conditions; combination of these diseases contributes to high level of disability and poor prognosis. The objective of the research is studying of demographic and clinical profile as well as treatment effectiveness of patients with AH and COPD based on National Register of Arterial Hypertension. Methods and materials. Among the analyzed selection, consisted of 32 571 patients with AH, who were followed up in the primary medical care, at the average age of 64±7 years old (there were 64% women of them), 5.4% patients with AH had COPD. The analysis of cardiovascular and cerebrovascular diseases frequency as well as treatment effectiveness was made. Results. According to National Register of Arterial Hypertension, cardiovascular [coronary heart disease, Q myocardial infarction, chronic heart failure (CHF), peripheral artery atherosclerosis] and cerebrovascular (stroke/transitory ischemic attack) diseases are accurately more often diagnosed at patients with AH and COPD. Conclusion. Male sex and age are the strongest independent factor, contributing into the risk of development of cardiovascular diseases at these patients. COPD considerably increases the risk of CHF development. The conducted analysis has shown that treatment, prescribed to patients with AH and COPD meets modern recommendations.

Clinical practice guidelines on the diagnosis and treatment of patients with arterial hypertension and chronic obstructive pulmonary disease

“…Частота АГ у больных ХОБЛ варьирует от 6,8 до 76,3%, составляя в среднем 34,3%, что зависит от исследуемого контингента больных и методов диагностики заболеваний органов дыхания (спирометрия, рентгенография органов грудной клетки и др.) [30,31]. ХОБЛ выявляется у каждого 4-го больного АГ в возрасте от 25 до 64 лет [32,33].…”

“…Частота этого заболевания увеличивается с возрастом. Наиболее высо-кая встречаемость отмечается в возрасте 60-70 лет и у мужчин (82%) [7,30,[34][35][36]. По данным Росстата, болезни системы кровообращения занимают лидирующую позицию в структуре смертности в России [37].…”

Relationship of gene polymorphism with the nature of target organ damage in patients with arterial hypertension

“…Одной из ведущих причин высокой смертности населения от основных сердечно-сосудистых осложнений (ССО), доля которых в структуре общей смертности колеблется в диапазоне 30 -50 % [1], является артериальная гипертония (АГ), которая по-прежнему остается серьезной проблемой современной кардиологии.…”

Arterial hypertension with comorbid chronic obstructive pulmonary disease: relationship between tolerance to physical exercise and structural and functional state of the heart.

“…The combination of cardiovascular and bronchopulmonary pathology in the general population leads to unfavorable prognosis and disability [14,17]. COPD is diagnosed in every fourth patient with hypertension between the age of 25 and 64 years, so early diagnosis, treatment and rehabilitation of a patient with a combination of hypertension and COPD is required [1,3,4].…”

“…Disorder of the daily profile of BP in patients with hypertension in combination with COPD is characterized by the predominance of "non-dipper" and "night-peaker" types, which increases the risk of damage to target organs and adversely affect the prognosis [9]. A direct correlation was found between hypoxemia, the grade of BP elevation, sympathetic activity and a correlation between a decrease in FEV 1 , desaturation, and variability in the BP night profile [4,18]. However, the question of the relationship between exercise tolerance and hypoxemia in patients with hypertension combined with stable COPD remains unclear.…”