AGGRAVATING EFFECT OF ARTERIAL HYPERTENSION ON THE COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN PATIENTS WITH COMORBID PATHOLOGY.

OBJECTIVE: The aim: To study the effect of arterial hypertension on the course of chronic obstructive pulmonary disease in patients with comorbid pathology. PATIENTS AND METHODS: Materials and methods: The prospective study included 61 patients with COPD: 32 stable male patients with COPD with comorbid arterial hypertension of stage II 1-3 degrees and 29 stable outpatients of men with COPD of clinical groups A-D with impaired respiratory function II-IV according to GOLD. All patients, in accordance with the goals and objectives of the study, were divided into 2 groups: group I consisted of men with isolated COPD, middle age - 56.0 (8.5) years, average duration of the disease - 16.2 (1.3) years, Group II consisted of male patients with COPD and arterial hypertension (AH), middle age - 59.5 (7.5). The patients underwent a general clinical examination, which included an assessment of complaints, anamnestic data, and a physical examination. The severity of COPD was determined on the basis of the frequency of exacerbations during the year, assessment of dyspnea using the mMRS scale, spirographic data. Statistical materials were processed using the STATISTICA 10.0 program. RESULTS: Results: In group I, 20 patients (69%) complained of dyspnea during exercise, in group II - 25 patients (78%) (p = 0.4), 28 patients (96.5%) complained of cough with vague sputum. group and 30 patients in group II (93.8%) (p = 0.09). When assessing the number of exacerbations over the past year, it was determined that patients with isolated COPD had an average of 1.0 (1.0; 2.0) exacerbations, and patients with COPD and AH - 2.0 (1.0; 3.0 ) (p = 0.06). According to the CAT questionnaire, the following data were obtained: in group I - 9.0 (8.0; 11.0) points, and in group II - 17.5 (10.0; 20.0) points (p = 0.02). When conducting spirographic studies, a statistically significant more expressive bronchial obstruction was found in patients with COPD and comorbid hypertension. CONCLUSION: Conclusions: The presence of comorbid arterial hypertension leads to the intermittent effect of diseases: according to the results of mMRC and SAT test, ailments for COPD were examined, they have a more severe course of underlying seizure in the presence of concomitant arterial hypertension. Clinical manifestations in patients with COPD and H are more severe compared to clinical manifestations in patients without aggravated diseases of the cardiovascular system. Concomitant arterial hypertension enhances the manifestations of bronchial obstruction, in the same way as with patients with isolated COPD.

THE EFFECT OF SMOKING ON NUTRITIONAL STATUS, SEVERITY OF THE DISEASE AND THE DEVELOPMENT OF SYSTEMIC EFFECTS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.

OBJECTIVE: The aim: To determine the effect of smoking on indicators of nutritional status in patients with chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: Materials and methods: A study included 91 patients with COPD. Patients were divided into two groups depending on the status of smoking: smokers and non-smokers. Everyone underwent an assessment of the severity of COPD, a study of nutritional status, a laboratory study of kidney function and blood lipid profile. RESULTS: Results: It was found that in smokers with COPD, the disease proceeds with more pronounced shortness of breath. There is also a development of sarcopenic obesity in those patients who smoke. In turn, it was found that bronchial obstruction increases with a decrease in muscle tissue content. Renal filtration function is reduced in smokers and non-smokers. CONCLUSION: Conclusions: 1. Patients suffering from COPD have a violation of nutritional status. Smoking patients develop sarcopenic obesity, which progresses with an increase in the degree of nicotine addiction, correlates with the "pack / year" index and is a predictor of increased mortality in this category of patients. 2. Increased bronchial obstruction in smokers with COPD is observed with an increase in smoking history, the number of cigarettes smoked and with a decrease in body weight. 3. Reducing the pool of muscle tissue can be considered as an early predictor of more frequent exacerbations in smoking patients with COPD. 4. The systemic effects of COPD include impaired renal function, more pronounced in smokers with COPD.