Influence of losartan on structural and functional remodelling of cardiovascular system in comorbidity of chronic obstructive lung disease and arterial hypertension

Abstract

Aim. To assess the influence of losartan treatment for comorbid chronic obstructive lung disease (COPD) and arterial hypertension (AH) on arterial pressure variability (BP), diastolic function and remodelling of the left ventricle myocardium (LV). Material and methods . Totally, 50 patients with AH and COPD included, mean age 59,8±7,9 y. Depending on the level of mean-daily BP variability (BPV) patients were selected to subgroups with normal (n=15) and increased (n=35) BPV. Results. Patients with normal BPV had concentric hypertrophy type of LV and moderate diastolic dysfunction of LV mostly with relaxation disorder, but in COPD+AH with higher BPV patients there were more prominent structural and geometric LV disorders with tendency to eccentric LV hypertrophy, as more significant diastolic function disorders with the part of patients having pseudonormal diastolic dysfunction type. Conclusion . With inclusion of losartan to the protocol of patients’ treatment, there is decrease of structural impairment of the LV that is the lowering of end diastolic LV size, LV myocardial mass, increase of ejection fraction, increase of the number of patients having normal LV geometry, decrease of signs of diastolic dysfunction. In losartan prescription, there is better adherence of patients to treatment.