Features of Changes of Vascular Age and Cardiovascular Risk Level in Patients with Arterial Hypertension and Comorbid Chronic Obstructive Pulmonary Disease

Abstract

The objective: Evaluate changes in vascular age and cardiovascular risk level with reference to the severity of chronic obstructive pulmonary disease (COPD) in patients with arterial hypertension (AH) and COPD. Materials 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 (group 1), 30 patients with AH without COPD (group 2), 30 patients with COPD without AH (group 3) and 30 healthy individuals (control group) representative by age and sex. Results. In the group of patients with AH and comorbid COPD, more than 50% of patients corresponded to moderate CVR, more than a third to high CVR, and a very high risk was found in isolated cases. The analysis of the obtained data revealed a significant increase in vascular age relative to chronological in groups 1, 2 and 3, but in control group there was only a tendency to ahead of vascular age (p>0.05). The diagnostic value of indicators for determining the exacerbation of COPD in patients with hypertension and comorbid COPD was determined using ROC analysis, which showed the presence of prognostic value for the following factors: age (AUC 0.50; CI 0.41–0.59), pack-years (AUC 0.60; CI0.51–0.69), duration of COPD (AUC 0.60; CI 0.51–0.69). Conclusion. The GP of the family medicine must evaluate the CVR on the SCORE scale as a screening technique. In the presence of comorbid COPD, the factor of disease duration becomes significant, which is an additional risk factor and affects the severity of CVR. Regardless of the comorbid pathology of AH and COPD, patients have a discrepancy between vascular and chronological age, which is a predictor of cardiovascular disease.