Clinical portrait and features of antihypertensive therapy in comorbid patients with arterial hypertension and chronic obstructive pulmonary disease according to the national hypertension registry

Background. Cardiovascular diseases (CVD) and chronic obstructive pulmonary disease (COPD) are the two leading causes of death in the world. Studies show a close mutually aggravating relationship between arterial hypertension (AH) and COPD. Antihypertensive therapy in patients with AH and COPD has a...

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Main Authors: Anna V. Aksenova, Ivan S. Serov, Olga А. Belova, Svetlana А. Rachkova, Irina E. Chazova
Format: Article
Language:Russian
Published: "Consilium Medicum" Publishing house 2025-01-01
Series:Терапевтический архив
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Online Access:https://ter-arkhiv.ru/0040-3660/article/viewFile/677086/203816
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author Anna V. Aksenova
Ivan S. Serov
Olga А. Belova
Svetlana А. Rachkova
Irina E. Chazova
author_facet Anna V. Aksenova
Ivan S. Serov
Olga А. Belova
Svetlana А. Rachkova
Irina E. Chazova
author_sort Anna V. Aksenova
collection DOAJ
description Background. Cardiovascular diseases (CVD) and chronic obstructive pulmonary disease (COPD) are the two leading causes of death in the world. Studies show a close mutually aggravating relationship between arterial hypertension (AH) and COPD. Antihypertensive therapy in patients with AH and COPD has a number of features, aiming to reduce the risk of developing cardiovascular complications and mortality from CVD without worsening lung function. Aim. To analyze the data of patients with AH and COPD included in the national registry to determine the burden of CVD risk factors, concomitant cardiovascular, cerebrovascular diseases and chronic kidney disease, obesity, diabetes mellitus, gout and characteristics of antihypertensive therapy. Materials and methods. A comparative analysis of patients of the hypertension registry (conducted in outpatient clinics) was performed depending on the presence (n=3323) or absence (n=54073) of chronic obstructive pulmonary disease. Statistical analysis of the obtained data were performed using the R 4.3.3 statistical computing environment (R Foundation for Statistical Computing, Vienna, Austria). Results. The prevalence of COPD in patients with hypertension was 5.8% (3323 cases). The presence of COPD in patients with hypertension, regardless of gender and age, was statistically significantly associated with higher odds of having coronary artery disease [odds ratio (OR) 2.21, 95% confidence interval (CI) 2.06–2.38; p0.001], a history of myocardial infarction (OR 1.73, 95% CI 1.59–1.87; p0.001), chronic heart failure (OR 1.95, 95% CI 1.82–2.1; p0.001), a history of acute cerebrovascular accident (OR 1.25, 95% CI 1.07–1.46; p=0.004), transient ischemic attack (OR 2.9, 95% CI 2.31–3.59; p0.001), atrial fibrillation (OR 1.68, 95% CI 1.45–1.93; p0.001). Patients with hypertension and COPD more often received drugs from the group of angiotensin-II receptor antagonists than patients with hypertension without COPD (22.7% vs 17.7%). The prescription of drugs from the group of beta-blockers in patients with hypertension and COPD was lower by 4%. Cardiovascular risk factors, comorbidities such as diabetes mellitus, gout, obstructive sleep apnea in patients with hypertension and COPD are more common. Conclusion. Patients with COPD and hypertension have a higher incidence of risk factors, CVD and comorbid pathologies. They require closer attention during examination and during the selection of antihypertensive therapy. In patients with hypertension and COPD, angiotensin-converting-enzyme inhibitors and beta-blockers are prescribed less frequently than in patients with hypertension without COPD due to possible side effects and contraindications.
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spelling doaj-art-e28c992db85f43899f2c360fdf313acc2025-08-20T02:55:10Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422025-01-0197753854410.26442/00403660.2025.07.20329578692Clinical portrait and features of antihypertensive therapy in comorbid patients with arterial hypertension and chronic obstructive pulmonary disease according to the national hypertension registryAnna V. Aksenova0https://orcid.org/0000-0001-8048-4882Ivan S. Serov1https://orcid.org/0009-0007-8543-1326Olga А. Belova2https://orcid.org/0000-0002-7164-0086Svetlana А. Rachkova3https://orcid.org/0000-0003-0833-8201Irina E. Chazova4Chazov National Medical Research Center of CardiologyCardiological DispensaryCardiological DispensaryCardiological DispensaryChazov National Medical Research Center of CardiologyBackground. Cardiovascular diseases (CVD) and chronic obstructive pulmonary disease (COPD) are the two leading causes of death in the world. Studies show a close mutually aggravating relationship between arterial hypertension (AH) and COPD. Antihypertensive therapy in patients with AH and COPD has a number of features, aiming to reduce the risk of developing cardiovascular complications and mortality from CVD without worsening lung function. Aim. To analyze the data of patients with AH and COPD included in the national registry to determine the burden of CVD risk factors, concomitant cardiovascular, cerebrovascular diseases and chronic kidney disease, obesity, diabetes mellitus, gout and characteristics of antihypertensive therapy. Materials and methods. A comparative analysis of patients of the hypertension registry (conducted in outpatient clinics) was performed depending on the presence (n=3323) or absence (n=54073) of chronic obstructive pulmonary disease. Statistical analysis of the obtained data were performed using the R 4.3.3 statistical computing environment (R Foundation for Statistical Computing, Vienna, Austria). Results. The prevalence of COPD in patients with hypertension was 5.8% (3323 cases). The presence of COPD in patients with hypertension, regardless of gender and age, was statistically significantly associated with higher odds of having coronary artery disease [odds ratio (OR) 2.21, 95% confidence interval (CI) 2.06–2.38; p0.001], a history of myocardial infarction (OR 1.73, 95% CI 1.59–1.87; p0.001), chronic heart failure (OR 1.95, 95% CI 1.82–2.1; p0.001), a history of acute cerebrovascular accident (OR 1.25, 95% CI 1.07–1.46; p=0.004), transient ischemic attack (OR 2.9, 95% CI 2.31–3.59; p0.001), atrial fibrillation (OR 1.68, 95% CI 1.45–1.93; p0.001). Patients with hypertension and COPD more often received drugs from the group of angiotensin-II receptor antagonists than patients with hypertension without COPD (22.7% vs 17.7%). The prescription of drugs from the group of beta-blockers in patients with hypertension and COPD was lower by 4%. Cardiovascular risk factors, comorbidities such as diabetes mellitus, gout, obstructive sleep apnea in patients with hypertension and COPD are more common. Conclusion. Patients with COPD and hypertension have a higher incidence of risk factors, CVD and comorbid pathologies. They require closer attention during examination and during the selection of antihypertensive therapy. In patients with hypertension and COPD, angiotensin-converting-enzyme inhibitors and beta-blockers are prescribed less frequently than in patients with hypertension without COPD due to possible side effects and contraindications.https://ter-arkhiv.ru/0040-3660/article/viewFile/677086/203816hypertension registryarterial hypertensionantihypertensive therapychronic lung diseasemyocardial infarctionchronic heart failurebeta-blockersangiotensin-converting enzyme inhibitorscalcium channel blockers
spellingShingle Anna V. Aksenova
Ivan S. Serov
Olga А. Belova
Svetlana А. Rachkova
Irina E. Chazova
Clinical portrait and features of antihypertensive therapy in comorbid patients with arterial hypertension and chronic obstructive pulmonary disease according to the national hypertension registry
Терапевтический архив
hypertension registry
arterial hypertension
antihypertensive therapy
chronic lung disease
myocardial infarction
chronic heart failure
beta-blockers
angiotensin-converting enzyme inhibitors
calcium channel blockers
title Clinical portrait and features of antihypertensive therapy in comorbid patients with arterial hypertension and chronic obstructive pulmonary disease according to the national hypertension registry
title_full Clinical portrait and features of antihypertensive therapy in comorbid patients with arterial hypertension and chronic obstructive pulmonary disease according to the national hypertension registry
title_fullStr Clinical portrait and features of antihypertensive therapy in comorbid patients with arterial hypertension and chronic obstructive pulmonary disease according to the national hypertension registry
title_full_unstemmed Clinical portrait and features of antihypertensive therapy in comorbid patients with arterial hypertension and chronic obstructive pulmonary disease according to the national hypertension registry
title_short Clinical portrait and features of antihypertensive therapy in comorbid patients with arterial hypertension and chronic obstructive pulmonary disease according to the national hypertension registry
title_sort clinical portrait and features of antihypertensive therapy in comorbid patients with arterial hypertension and chronic obstructive pulmonary disease according to the national hypertension registry
topic hypertension registry
arterial hypertension
antihypertensive therapy
chronic lung disease
myocardial infarction
chronic heart failure
beta-blockers
angiotensin-converting enzyme inhibitors
calcium channel blockers
url https://ter-arkhiv.ru/0040-3660/article/viewFile/677086/203816
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