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№2' 2021


International Medical Journal, Vol. 27., Iss. 2, 2021, P. 5−9.



Vlasenko O. M., Butikova O. O.

Kharkiv Medical Academy of Postgraduate Education, Ukraine

Arterial hypertension is the most common comorbid condition in the patients with chronic obstructive pulmonary disease. These diseases spread among one age group of patients with frequent development of coronary heart disease, the main cause of which is atherosclerosis. The increased association of these pathologies is explained by the presence of common pathogenetic mechanisms, i.e. chronic systemic inflammation, endothelial dysfunction, activation of sympathoadrenal and renin−angiotensin−aldosterone systems with the progression of pathological vasoconstrictor reaction. Cardiovascular effects caused by endothelial dysfunction, atherosclerosis, and hypertension are currently considered as potentially systemic manifestations of chronic obstructive pulmonary disease. To establish the effect of the combined use of fosinopril, nebivolol and atorvastatin on markers of chronic systemic inflammation and endothelial dysfunction (TNF−α, hsSRP, endothelin−1), lipid spectrum parameters, respiratory function in patients with stage II hypertension in combination with chronic obstructive pulmonary disease of stage I−II. There were examined 127 patients. They were two groups randomized, one of which received standard antihypertensive therapy (ACE inhibitor + dihydropyridine antagonist Ca2 + + thiazide diuretic), the other composed a combination of drugs (fosinopril + nebivolol + atorvastatin + thiazide diuretic). Clinical examination of patients included the study of anamnesis, objective condition, results of instrumental and biochemical studies. It was found that the combination therapy with fosinopril, nebivolol and atorvastatin for 32 weeks led to a significant reduction in endothelin−1, TNF−α, hsSRP, normalized the lipid spectrum, allowed the achievement of target blood pressure levels and did not impair external function.

Key words: arterial hypertension, chronic obstructive pulmonary disease, endothelial dysfunction, chronic systemic inflammation.


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