ASSESSMENT OF TOTAL CARDIOVASCULAR RISK IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBID CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

The aim – to determine the total cardiovascular risk (CVR) in patients with AH and comorbid COPD.

Material and Methods. The study included 120 patients with hypertension stage II, grade 2, 3 and 3 in combination with COPD grade II-III and clinical groups A, B, C, D. The study methods included general clinical examination (collection of complaints, medical history, clinical examination, anthropometric parameters), laboratory (blood lipids, blood glucose, blood creatinine, calculated glomerular filtration rate according to CKD-EPI) and instrumental methods (electrocardiography, Doppler echocardiography, ambulatory blood pressure monitoring, spirometry).

Results. The SCORE scale revealed that in one case there were no individuals with low CVR among patients with AH and comorbid COPD. In the patient group, 57.5 % were found to have a moderate CVR, 36.7 % had a high CVR, and a very high risk was established in 5.8 % of cases. Pulse pressure, aortic stiffness index, ECG and EchoCG signs of left ventricular hypertrophy, and glomerular filtration rate were analyzed to detect asymptomatic hypertensive target organ damage. The patients were stratified by determining the total CVR. It was found that there were no patients with a moderate degree of CVR in group 1, the number of patients with a high degree of CVR increased to 85.0 %, and a very high degree of CVR increased to 15.0 %.

Conclusion. The cardiovascular risk in patients with AH and comorbid COPD depends not only on the degree of AH, the profile of cardiac risk factors and target organ damage, but also on the degree and clinical group of COPD. An increase in overall cardiovascular risk has been revealed, which requires the inclusion of COPD to the prognostic extracardiac risk factors in patients with AH.