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.
Highlights
Arterial hypertension (AH) is a major cause of mortality, premature morbidity and disability, and a key risk factor (FR) for coronary heart disease (CHD), cerebrovascular disease, heart failure (CHF), chronic kidney disease and dementia [1]
According to modern AH guidelines, special attention is paid to the SCORE scale, which is simple, valid and informative enough, but still does not cover a wide range of FR, hypertensive target organ damage and associated clinical conditions
The concept of total cardiovascular risk (CVR) is generally recognized, according to which FR are not specified in the SCORE scale are taken into account, left ventricular hypertrophy (LVH) according to electro cardiography (ECG) and Doppler echocardiography (DECG), glomerular filtration rate (GFR) according to CKD-EPI formula, arterial stiffness), which actualizes further research of this issue, in the case of cohort patients with AH and comorbid COPD
Summary
Arterial hypertension (AH) is a major cause of mortality, premature morbidity and disability, and a key risk factor (FR) for coronary heart disease (CHD), cerebrovascular disease, heart failure (CHF), chronic kidney disease and dementia [1]. The concept of total (global) cardiovascular risk (CVR) is generally recognized, according to which FR are not specified in the SCORE scale (fasting plasma glucose, excessive body weight, a heavy family history of AH, resting heart rate over 80/min) are taken into account, left ventricular hypertrophy (LVH) according to electro cardiography (ECG) and Doppler echocardiography (DECG), glomerular filtration rate (GFR) according to CKD-EPI formula, arterial stiffness), which actualizes further research of this issue, in the case of cohort patients with AH and comorbid COPD. The aim – to determine the general cardio vascular risk in patients with AH and comorbid COPD
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