#6332 INFLUENCE OF NUTRITIONAL STATUS ON THE INCREASE IN CARDIOVASCULAR RISK AND THE RISK OF KIDNEY DAMAGE IN COMORBIDITY OF HYPERTENSION AND COPD

Abstract

Abstract Background and Aims It is widely known that obesity is a modulated additional factor in increasing cardiovascular risk in patients with hypertension. Since the number of patients with comorbidity of arterial hypertension and COPD is increasing, the question of the relationship between nutritional status and cardiovascular risk remains relevant. Purpose of the study: to determine the role of nutritional status indicators in the formation of cardiovascular risk in patients with comorbidity of hypertension and COPD. Method 101 patients were included in a cross-sectional study: 32 patients with comorbidity of hypertension and COPD (Gr I), 43 patients with hypertension (Gr II), and 26 patients with chronic obstructive pulmonary disease (Gr III). Exclusion criteria: informed consent of the patient to processing of personal data, Hypertension stage II, 1-3 degree, COPD A - C clinical groups(stable phase), age≥40 years. Exclusion criteria: age≥80 years, myocardial infarction and cerebral circulatory disorders, kidney diseases (polycystosis, developmental abnormalities, glomerulonephritis, pyelonephritis), diabetes mellitus, cancer, GFR < 30 ml/min. Patients underwent general clinical examination, determined nutritional status by anthropometric study and bioimpedancemetry, assessed the renal function by laboratory examination of blood. Methods of parametric and nonparametric statistics were used. Results A high cardiovascular risk in Gr I was in 22 (68,8%) patients, in Gr II - in 27 (62,9%) patients and in Gr III - in 10 (38,5%) patients. GFR in Gr I was 67,5 (57,0;77,0) ml/min, in Gr II -70.6 (57.0; 83.0) ml/min, and in Gr III - 82.5 (70.0;89.0) ml/min (p = 0.02). BMI in Gr I was 30.2 (26.5;35.0) kg/m2, in GrII - 29.7 (26.3;33.9) kg/m2, in GrIII - 26.8 (24.6;29.6) kg/m2. Percentage of adipose tissue in Gr I was 35.1 (30.0;41.7), in Gr II-38.2 (32.4;42.1) and in Gr III - 27.7 (21.0;34.1) (p = 0.01). The total muscle tissue in Gr I was 28,6 (24,6;30,6)%, in Gr II - 28,5 (25,0;31,2)%, in Gr III - 32,1 (27,8;35,3)%(p = 0.1), visceral fat in Gr I was 11,0 (8,0;14,0)%, in Gr II- 11,0 (9,0;15,0) %, in Gr III- 9,0 (6,0;13,0) %(p = 0.1); sarcopenia index in Gr I was 77,8(61,6;86,2), in Gr II- 77,8(66,1;101,8), in Gr III- 90,6(86,0;98,6)(p = 0,1). In Gr I, correlations were found: negative between GFR and high cardiovascular risk (R = -0.6), positive - between sarcopenia index, visceral fat and high cardiovascular risk (R = 0.5; 0.6), negative - between the amount of muscle tissue and high cardiovascular risk in patients (R = -0.5) (p<0,05). Conclusion In patients with a comorbidity of hypertension and COPD, along with an increase in the amount of adipose tissue and visceral fat, the amount of muscle tissue decreases, which leads to sarcopenic obesity. Sarcopenic obesity is associated with high cardiovascular risk and worsening of renal function, which also leads to an increased risk of cardiovascular complications.