Abstract
We found a high frequency of co-occurrence of arterial hypertension and chronic obstructive pulmonary disease (COPD) in the therapeutic practice of 130 patients. Objective . To investigate daily ECG monitoring results and heart rate variability (HRV) in patients with a combination of hypertension and COPD. Material and Methods. A total of 130 patients with arterial hypertension were examined. The main group ( n = 90) consisted of comorbid patients with arterial hypertension suffering of COPD, mean age of 61.3 ± 1.0 years. The comparison group ( n = 40) comprised hypertensive patients without COPD, with a mean age of 59.1 ± 1.5 years. All patients received 24-hour ECG monitoring with HRV assessment. Results. Analysis of heart rhythm abnormalities and cardiac conduction disorders allowed to detect the following arrhythmias in patients with hypertension in the presence of COPD: paired supraventricular extrasystoles, runs of supraventricular tachycardia, paroxysmal atrial fibrillation, Lown grade I ventricular extrasystoles, and paired ventricular extrasystoles. The right bundle-branch block was the most frequent conduction disorder observed in patients with COPD. Temporal analysis of HRV showed that the basic daily-average parameters responsible for the overall tone of the autonomic nervous system (SDNN, SDNNi, and SDANN) and the indicators reflecting the effects of parasympathetic regulation on the heart activity (RMSSD, pNN50, and HRVTI) were attenuated in comorbid patients. Conclusion. This study showed that patients with arterial hypertension associated with COPD were more prone to the occurrence of potentially dangerous arrhythmias. Heart rate variability in such patients was characterized by a decrease in the tone of the parasympathetic division of the autonomic nervous system and the predominance of sympathetic effects on cardiac activity.
Highlights
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(Med.), Professor, Department of Therapy, Gastroenterology, Cardiology and General Medical Practice (Family Medicine), Faculty of Medical Personnel Training of Higher Qualification and Additional Professional Education, Medical Academy named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University
Summary
В группу сравнения (группа 2) вошли 40 пациентов только с АГ, средний возраст – 59,1 ± 1,5 года, 19 (45,2%) мужчин и 23 (54,8%) женщины; длительность заболевания составила 9,8 ± 0,3 года. Пациентов включали в исследование на основании следующих критериев: установленный диагноз АГ II стадии 12-й степени, риск III, ХОБЛ GOLD 2, группа В. При изучении различий количественных переменных при условии их нормального распределения в исследуемых группах использовали параметрический критерий Стьюдента, предварительно сравнив дисперсии. Статистическую значимость различий данных, представленных в абсолютных частотах, определяли с использованием критерия «угловое преобразование Фишера» с двусторонней критической областью. Вывод о наличии статистически значимых различий делали при значении вышеуказанных критериев р < 0,05. При проведении корреляционного анализа при нормальном распределении признака использовали критерий Пирсона, в случае распределения, отличного от нормального, – критерий Спирмена. Оценивали статистическую значимость полученных коэффициентов корреляции, их силу и направленность
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