CARDIOVASCULAR RISK FACTORS AND MANIFESTATION OF PERSISTENT SYSTEMIC INFLAMMATION IN PATIENTS WITH COMORBIDITY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND HYPERTENSION

Abstract

An increase of the level of persistent systemic inflammation, one of the important biomarkers of which is the C-reactive protein (CRP), is considered as a factor contributing to the occurrence of serious cardiovascular events in patients with cardiovascular pathology and in patients with chronic obstructive pulmonary disease (COPD).

The aim of the study – to determine the level of serum ultra-sensitive C-reactive protein (hsCRP), its connection with cardiovascular risk factors, activity of platelets (Pl) in patients with comorbidity COPD and arterial hypertension (AH).

Material and Methods. The study included 84 patients in a stable condition. The group I – 44 patients with COPD in combination with AH stage І–ІІ, the group II – 40 patients with H stage І – ІІ. The following indicators were determined: office blood pressure (BP), body mass index (BMI), smoking status and assessment of the degree of nicotine dependence (Fagerstrom Test for Nicotine Dependence – FTND); it was determined the high sensitivity of serum C-reactive protein concentration (hsCRP) by IFA-test, lipid profile, adhesion, induced aggregation (Agr) of thrombocytes (Pl) and fibrinogen (FG); in the group I, there was an assessment of dyspnea by mMRS, frequency of exacerbations during the year, spirography.

Results. Level of hsCRP in the group I was irrespective of age, BMI, smoking status, lipid profile, but was associated with an increase in wheeze and mMRS level (p<0.05). At BMI≤25 kg/m² in the group I it was higher than in the group II (p=0.007), in the group II hsCRP was higher at BMI>25 kg/m² than at BMI≤25 kg/m² (0.008) in smokers (0.016) and was associated with dyslipidemia (p<0.05). Induced by collagen, thrombin Pl Agr in the group I it had a reverse correlation with hsCRP, in the group II, induced by collagen Pl Agr it had a direct correlation with hsCRP (p<0.05), but the total adhesion and aggregation activity of Pl in the group I was higher than in the group II. In the group I the level of FG had a direct correlation with hsCRP and the reverse one with FEV₁.

Conclusions. Increase the levels of hsSRP and FG in stable COPD patients with combined AH is associated with respiratory disorders. In patients with AH – hsSRB increases with an increase in BMI, dyslipidemia, dependence on smoking. The general prothrombotic potential in patients of the group I higher than in the group II, which is due to an increase in the adhesive-aggregation activity of TP, as well as an increase in fibrinogenemia with an increase in the level of hsSRB. Increased levels of hsSRB, FG and Pl activity in comorbid patients with COPD and AH contribute to the risk of serious cardiovascular events even in the absence of exacerbations.