CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTS

Studies of endothelial dysfunction in patients with respiratory diseases have become relevant in recent years. Perhaps endothelial dysfunction and high arterial stiffness bind bronchopulmonary and cardiovascular diseases.Aim. To reveal features of disturbances of arterial wall vasoregulatory functio...

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Main Authors: N. A. Karoli, A. P. Rebrov
Format: Article
Language:English
Published: Столичная издательская компания 2017-09-01
Series:Рациональная фармакотерапия в кардиологии
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Online Access:https://www.rpcardio.online/jour/article/view/1512
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author N. A. Karoli
A. P. Rebrov
author_facet N. A. Karoli
A. P. Rebrov
author_sort N. A. Karoli
collection DOAJ
description Studies of endothelial dysfunction in patients with respiratory diseases have become relevant in recent years. Perhaps endothelial dysfunction and high arterial stiffness bind bronchopulmonary and cardiovascular diseases.Aim. To reveal features of disturbances of arterial wall vasoregulatory function in patients with chronic obstructive pulmonary disease (COPD) in the presence and absence of arterial hypertension (HT).Material and methods. The study included 50 patients with COPD with normal blood pressure (BP) and 85 patients with COPD and HT. Control group was presented by 20 practically healthy men comparable in age with COPD patients. Tests with reactive hyperemia (endothelium-dependent dilation) and nitroglycerin (endothelium-independent dilation) were performed in order to evaluate endothelium function. The number of desquamated endotheliocytes in the blood was determined.Results. In patients with COPD and HT in comparison with COPD patients without HT and healthy individuals more pronounced damages of the vascular wall, endothelium vasoregulatory function disturbances and a tendency to the reduction in endothelium-dependent vasodilation were determined both during COPD exacerbation and remission. These differences were most pronounced during the COPD exacerbation. In patients with COPD and HT in comparison with COPD patients without HT the damage of the vascular wall was more pronounced during the remission and endothelium-dependent dilatation disorder – during the exacerbation. The revealed disorders in patients with COPD and HT were associated with smoking status (r=0.61, p<0.01), severity of bronchial obstruction (r=-0.49, p<0.05), and hypoxemia (r=-0.76, p<0.01). We noted relationships between the parameters of 24-hour BP monitoring and remodeling of the brachial artery (r=0.34, p<0.05), endothelium lesion (r=0.25, p<0.05), and impairment of its vasoregulating function (r=-0.58, p<0.05). At that, the following parameters were important: the average systolic and diastolic BP levels, the BP load and variability indices, the time and rate of morning surge in systolic BP, and the circadian rhythm of BP.Conclusion. The obtained data show the aggravation of the severity of the vascular wall damages and the reduction in the endothelium vasoregulating activity in patients with COPD after development systemic HT. This effect is more evident during the exacerbation of bronchopulmonary disease.
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spelling doaj-art-199877bce5b74ec09c77419e23eea9212025-08-23T10:00:28ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532017-09-0113451351810.20996/1819-6446-2017-13-4-513-5181370CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTSN. A. Karoli0A. P. Rebrov1Saratov State Medical University named after V.I. RazumovskySaratov State Medical University named after V.I. RazumovskyStudies of endothelial dysfunction in patients with respiratory diseases have become relevant in recent years. Perhaps endothelial dysfunction and high arterial stiffness bind bronchopulmonary and cardiovascular diseases.Aim. To reveal features of disturbances of arterial wall vasoregulatory function in patients with chronic obstructive pulmonary disease (COPD) in the presence and absence of arterial hypertension (HT).Material and methods. The study included 50 patients with COPD with normal blood pressure (BP) and 85 patients with COPD and HT. Control group was presented by 20 practically healthy men comparable in age with COPD patients. Tests with reactive hyperemia (endothelium-dependent dilation) and nitroglycerin (endothelium-independent dilation) were performed in order to evaluate endothelium function. The number of desquamated endotheliocytes in the blood was determined.Results. In patients with COPD and HT in comparison with COPD patients without HT and healthy individuals more pronounced damages of the vascular wall, endothelium vasoregulatory function disturbances and a tendency to the reduction in endothelium-dependent vasodilation were determined both during COPD exacerbation and remission. These differences were most pronounced during the COPD exacerbation. In patients with COPD and HT in comparison with COPD patients without HT the damage of the vascular wall was more pronounced during the remission and endothelium-dependent dilatation disorder – during the exacerbation. The revealed disorders in patients with COPD and HT were associated with smoking status (r=0.61, p<0.01), severity of bronchial obstruction (r=-0.49, p<0.05), and hypoxemia (r=-0.76, p<0.01). We noted relationships between the parameters of 24-hour BP monitoring and remodeling of the brachial artery (r=0.34, p<0.05), endothelium lesion (r=0.25, p<0.05), and impairment of its vasoregulating function (r=-0.58, p<0.05). At that, the following parameters were important: the average systolic and diastolic BP levels, the BP load and variability indices, the time and rate of morning surge in systolic BP, and the circadian rhythm of BP.Conclusion. The obtained data show the aggravation of the severity of the vascular wall damages and the reduction in the endothelium vasoregulating activity in patients with COPD after development systemic HT. This effect is more evident during the exacerbation of bronchopulmonary disease.https://www.rpcardio.online/jour/article/view/1512chronic obstructive pulmonary diseasearterial hypertensionarterial wallendothelium dysfunction
spellingShingle N. A. Karoli
A. P. Rebrov
CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTS
Рациональная фармакотерапия в кардиологии
chronic obstructive pulmonary disease
arterial hypertension
arterial wall
endothelium dysfunction
title CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTS
title_full CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTS
title_fullStr CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTS
title_full_unstemmed CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTS
title_short CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTS
title_sort chronic obstructive pulmonary disease and arterial hypertension vascular wall as the target organ in comorbid patients
topic chronic obstructive pulmonary disease
arterial hypertension
arterial wall
endothelium dysfunction
url https://www.rpcardio.online/jour/article/view/1512
work_keys_str_mv AT nakaroli chronicobstructivepulmonarydiseaseandarterialhypertensionvascularwallasthetargetorganincomorbidpatients
AT aprebrov chronicobstructivepulmonarydiseaseandarterialhypertensionvascularwallasthetargetorganincomorbidpatients