scholarly journals Ultrasonic indicators of the heart and carotid arteries in arterial hypertension development in patients with chronic obstructive pulmonary disease

2016 ◽  
Vol 97 (4) ◽  
pp. 496-501 ◽  
Author(s):  
E G Akramova
Keyword(s):  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Arterial Hypertension ◽  
Pulmonary Disease ◽  
Ambulatory Blood Pressure ◽  
Carotid Arteries ◽  
Blood Pressure Monitoring ◽  
Chronic Obstructive ◽  
Duplex Scan ◽  
Obstructive Pulmonary Disease

Aim. To specify the sequence of changes in the functional parameters of arterial hypertension in patients with chronic obstructive pulmonary disease and asthma according to the results of echocardiography, carotid arteries duplex scan and ambulatory blood pressure monitoring.Methods. Ambulatory blood pressure monitoring, tissue Doppler echocardiography and carotid artery duplex scan were performed in 160 patients with chronic obstructive pulmonary disease, arterial hypertension, asthma, and 33 apparently healthy volunteers of both sexes aged 39-70 years.Results. In patients with chronic obstructive pulmonary disease, an increase in hypertensive indices of time and area with the development of non-dipper or inverse-dipper 24-hour blood pressure profile disturbances is registered only at night hours. In chronic obstructive pulmonary disease, unlike asthma, carotid arteries thickening, combined hypertrophy and diastolic dysfunction of both ventricles develop. The prevalence of the thickening of «intima-media» complex and atherosclerotic plaques among patients with comorbid pathology (chronic obstructive pulmonary disease + arterial hypertension) occurs significantly more frequently than in the groups with hypertension or chronic obstructive pulmonary disease, confirming the synergistic effect of the considered nosologies on the atherosclerotic process.Conclusion. In patients with chronic obstructive pulmonary disease changes of the ultrasonic and functional indicators of the cardiovascular system, typical for arterial hypertension are registered starting with stage I and amplified with increase in the disease severity, leading to the need of diagnostic and therapeutic management correction.

scholarly journals ATRIAL FIBRILLATION IN COMORBID PATIENTS DEPENDING ON THE TREATMENT REGIMEN

2019 ◽  
Vol 8 (2) ◽  
pp. 21-29 ◽  
Author(s):  
L. D. Khidirova ◽  
D. A. Yakhontov ◽  
S. A. Zenin
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Arterial Hypertension ◽  
Pulmonary Disease ◽  
Abdominal Obesity ◽  
Blood Pressure Monitoring ◽  
Clinical Status ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Aim. To study the clinical course of atrial fibrillation in patients with arterial hypertension and extracardiac comorbid pathology depending on the administered therapy.Methods. 207 men aged 45–65 years with atrial fibrillation (paroxysmal and persistent) and arterial hypertension in combination with diabetes mellitus (n = 40), abdominal obesity (n = 64) and chronic obstructive pulmonary disease (n = 47) were recruited to a observational cohort study. 56 patients with atrial fibrillation and arterial hypertension but without any extracardiac diseases were included in the comparison group. Clinical and anthropometric parameters were assessed in all patients. Adherence to therapy was estimated with the Morisky-Green test. All patients underwent ECG; electrocardiographic holter monitoring, 24-hour blood pressure monitoring with the Daily Monitoring Systems SCHILLER (Schiller, Switzerland), 2D and M-mode echocardiography using a Vivid 7 device (General Electric, USA). The statistical analysis was performed in the Rstudio software (version 0.99.879, RStudio, Inc., MA, USA).Results. 66% of patients with atrial fibrillation and arterial hypertension had concomitant extracardiac comorbid pathology, of them 20% of had diabetes mellitus, 22% with chronic obstructive pulmonary disease, and 24% with abdominal obesity. The clinical groups were comparable in electro impulse and drug therapy. Patients who received medical treatment were frequently admitted to hospitals for atrial fibrillation recurrence (p<0.001), compared with those who underwent electro impulse therapy. Adherence to antiarrhythmic therapy was low in the entire cohort of patients. There were no significant differences found between the clinical groups.Conclusion. Early diagnosis of the factors contributing to the progression of AF, the prescription of additional therapy for the secondary prevention of arrhythmia and the choice of its optimal treatment strategy may slow the progression of arrhythmia and the development of CHF, which will improve not only the clinical status of patients, but also their prognosis.

scholarly journals Influence of dosed walking on the course of arterial hypertension in patients with chronic obstructive pulmonary disease

2020 ◽  
Vol 1 (3) ◽  
pp. 68-74
Author(s):  
O. N. Kryuchkova ◽  
M. A. Bubnova ◽  
S. E. Bubnov
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Arterial Hypertension ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Role Functioning ◽  
Obstructive Pulmonary Disease

Objective: to study the influence of dosed walking on the course of hypertension and quality of life in patients with chronic obstructive pulmonary disease.Materials and methods: the study included 85 patients with a combination of arterial hypertension and chronic obstructive pulmonary disease, with an average age of 60.9 ± 1.06 years. Group A patients were prescribed dosed walking in addition to medication, while group B patients received only antihypertensive medications, statins, and basic treatment for chronic obstructive pulmonary disease. The effectiveness of treatment was determined after 6 weeks based on a standard examination, daily monitoring of blood pressure and ECG, and quality of life indicators. Long-term results were evaluated after 6 months.Results: patients whose treatment plan included physical training, in contrast to patients receiving only medication, noted a decrease in complaints of headache (p=0.034), dizziness (p=0.041), tachycardia (p=0.029), general weakness (p=0.003), head noise and tinnitus (p=0.018), sleep disturbance (p=0.010) and shortness of breath (p=0.004). They had normalization of all indicators of quality of life according to the SF-36 questionnaire: scales physical functioning (p<0.001), role functioning due to physical condition (p<0.001), pain intensity (p<0.001), general health (p=0.002), vital activity (p=0.001), social functioning (p=0.013), role functioning due to emotional state (p<0.001), mental health (p=0.008), physical component of health in general (p<0.001) and the mental health component (p=0.002). Improvement of well-being was accompanied by normalization of lipidogram indicators, daily heart rate and blood pressure: reduction of average daily indicators of blood pressure (p<0.001), pressure load index (p<0.001), blood pressure variability (p<0.05), pulse pressure (p<0.001) and the rate of morning rise in blood pressure (p<0.001).Conclusion: addition to standard medical therapy of dosed walking has a positive effect on the course of arterial hypertension in patients with chronic obstructive pulmonary disease.

scholarly journals Arterial stiffness of peripheral vasculature in patients with chronic obstructive pulmonary disease and its association with arterial hypertension

2013 ◽  
Vol 94 (6) ◽  
pp. 808-812
Author(s):  
V V Gajnitdinova ◽  
A B Bakirov ◽  
E Kh Akhmetzyanova ◽  
N F Berdikaeva ◽  
V B Zakirova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Arterial Hypertension ◽  
Pulmonary Disease ◽  
Arterial Wall ◽  
Carotid Arteries ◽  
Vascular Wall ◽  
Renal Arteries ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Common Carotid Arteries

Aim. To study the structural and functional state of vascular wall, arterial stiffness of large peripheral arteries (common carotid arteries, renal arteries) in patients with severe chronic obstructive pulmonary disease and its association with arterial hypertension. Methods. The study included 67 patients of working age, mainly males, having chronic obstructive pulmonary disease. Among them, 52 patients had severe chronic obstructive pulmonary disease (defined by GOLD III, 2011), 15 had concomitant arterial hypertension of I and II stage. Structural and functional status of common carotid arteries, renal arteries was assessed by measurement of intima-media thickness, arterial stiffness indexes were calculated. Arterial elasticity indices: arterial compliance, elastic index, Young’s elastic modulus were calculated based on the results of ultrasonography of main arterial wall parameters (diameter, arterial wall thickness) and blood pressure measurement. Results. A decrease in common carotid arteries and renal arteries wall elasticity was revealed in patients with chronic obstructive pulmonary disease. Increase of stiffness index in patients with severe chronic obstructive pulmonary disease associated with arterial hypertension, marking the decreased arterial wall elasticity, was registered both in common carotid arteries and renal arteries. Conclusion. In common carotid arteries vascular wall thickness contribute the most in vascular wall stiffness increase, compared to altered hemodynamics in renal arteries. Development of arterial hypertension in these patients is a predicting factor for further large vessel remodeling associated with hypoxia.

CHARACTERISTICS OF 24-HOUR BLOOD PRESSURE INDICATORS IN PATIENTS WITH HYPERTENSION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2020 ◽  
pp. 31-41
Author(s):  
M.A. Bubnova ◽  
O.N. Kryuchkova
Keyword(s):  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Mean Arterial Pressure ◽  
High Risk ◽  
Arterial Pressure ◽  
Pulmonary Disease ◽  
Comparison Group ◽  
Cardiovascular Complications ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Patients with hypertension (HT) and chronic obstructive pulmonary disease (COPD) have a high risk of cardiovascular complications. Up to now, there is no optimal strategy for combined antihypertensive therapy. Still, the data of 24-hour blood pressure monitoring (BPM) are important while choosing treatment tactics. The aim of the paper is to study the features of indicators in patients with arterial hypertension (AH) and COPD. Materials and methods. 130 patients with HT were included in the study. The main group (n=90) included comorbid patients with HT and COPD, their average age was 61.30±1.01; the comparison group (n=40) consisted of patients with HT, their average age was 59.10±1.53. All patients underwent 24-hour BPM. Results. Comorbid patients revealed an increase in the mean 24-hour and night systolic and mean arterial pressure values as well as a significant increase in the load index of systolic, diastolic and mean arterial pressure. Also, comorbid patients demonstrated higher blood pressure in contrast to the patients of the comparison group. They had increased systolic, diastolic and mean blood pressure variability and a quicker rate of morning blood pressure rise. According to 24-hour blood pressure dynamics, pathological types of the 24-hour blood pressure curve, a higher frequency of the night-peaker profile dominated in patients with COPD if compared to patients with HT. Conclusion. The obtained data indicated a high risk of cardiovascular complications in comorbid patients, early target organ damage and an unfavorable disease prognosis. It means that both further study of hypertension clinical course in such patients and personalization of antihypertensive therapy are relevant. Keywords: hypertension, chronic obstructive pulmonary disease, 24-hour monitoring, blood pressure. Пациенты с артериальной гипертензией (АГ) и хронической обструктивной болезнью легких (ХОБЛ) имеют высокий риск возникновения кардиоваскулярных осложнений. В настоящее время в лечении не определена наиболее оптимальная стратегия комбинированной антигипертензивной терапии. Для выбора тактики терапии важную роль играют показатели суточного мониторирования артериального давления (СМАД). Цель. Изучить особенности показателей СМАД у пациентов с АГ на фоне ХОБЛ. Материалы и методы. В исследование включено 130 пациентов с АГ. В основную группу (n=90) вошли пациенты с АГ и ХОБЛ (средний возраст – 61,30±1,01 года), в группу сравнения (n=40) – больные только АГ (средний возраст – 59,10±1,53 года). Всем пациентам проведено СМАД. Результаты. У пациентов с коморбидностью выявлены следующие особенности суточных показателей артериального давления: увеличение значений среднесуточных и средненочных показателей систолического и среднего артериального давления; существенное повышение индекса нагрузки систолическим, диастолическим и средним артериальным давлением. Также эти больные отличались от пациентов группы сравнения более высокими значениями пульсового давления, имели повышенную вариабельность систолического, диастолического и среднего артериального давления, у них наблюдалось увеличение скорости утреннего подъема артериального давления. Суточная динамика артериального давления у пациентов с ХОБЛ характеризовалась преобладанием патологических типов суточной кривой АД, более высокой частотой профиля night-peaker по сравнению с больными только АГ. Выводы. Выявленные особенности свидетельствуют о высоком риске сердечно-сосудистых осложнений у пациентов с коморбидностью, раннем поражении органов-мишеней и неблагоприятном прогнозе заболевания, что требует дальнейшего изучения особенностей клинического течения АГ у таких больных и индивидуализации антигипертензивной терапии. Ключевые слова: артериальная гипертензия, хроническая обструктивная болезнь легких, суточное мониторирование, артериальное давление.

Possibilities of cardiovascular events in patients with chronic obstructive pulmonary disease and newly diagnosed tuberculosis, including those associated with HIV infection, when prescribing long-acting β2-agonists

MedAlliance ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 32-39
Keyword(s):  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Tb Treatment ◽  
Long Acting ◽  
Β2 Agonists

Chronic obstructive pulmonary disease (COPD) and pulmonary tuberculosis (TB) are a common pathology among respiratory diseases. Both conditions may have common risk factors, aggravating each other, accom-panied by the development of bronchial obstructive syndrome, requiring mandatory medical correction to increase the effectiveness of therapy for both the main and concomitant pathologies. The aim of the study was to study the effectiveness of treatment of TB in patients with COPD first diagnosed with tuberculosis, including those associated with HIV when prescribing long-acting β2-agonists. Materials and methods. A simple com-parative study included 60 patients of a TB dispensary aged 30–65 years. Patients were divided into 2 groups of 30 people (TB+COPD and TB+COPD+HIV), each of whom for 2 months received a long-acting β-agonist (indacaterol) as an accompanying therapy for the cor-rection of bronchial obstructive syndrome (BOS), with subsequent assessment of the effectiveness of therapy. Results. Subjectively, patients of both groups noted the rapid development of positive dynamics (short-ness of breath decreased from 1–3 days of taking the drug, coughing — within a week, tolerance to physical exertion improved), which was confirmed by indica-tors of the function of external respiration (FEV1). The state of the cardiovascular system was assessed by the results of daily monitoring of blood pressure (BPM). In the COPD+TB group, there is a certain average daily systolic blood pressure (SBP) with a tendency to nor-malize indicators, which is possibly associated with a decrease in the severity of hypoxia during bronchodi-lator therapy. In the COPD+TB+HIV group, the average daily level of SBP increased by 1 mm Hg, but given the very low starting rates, the increase in blood pressure had a positive effect on the patients' condition. The average heart rate (HR) during bronchodilator thera-py did not tend to increase. The best TB treatment re-sults were obtained in the TB+COPD group. In terms of the closure rate of TB+COPD decay cavities — 26.6%, TB+COPD+HIV — 20.0%), the TB+COPD+HIV group had longer periods of abacillation and closure of decay cav-ities, which is associa ted with the severity of the under-lying and associated diseases. The drug was well toler-ated in both groups. Conclusion. The use of 300 mcg long-acting β-adrenomimetics in the complex therapy of β2-adrenergic agonists for patients with TB+COPD and TB+ COPD+HIV can reduce the severity of bronchial obstruction syndrome, improve quality of life, increase adherence to TB treatment, thereby shortening hospi-talization and reduce the likelihood of disability of pa-tients, without the development of side effects from other organs and systems.

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