State of bronchial pateness parameters and indicators of the daily blood pressure profile in patients with arterial hypertension in combination with COPD during cytoprotective therapy

The high frequency of the combination of arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) is due to a number of close pathogenetic relationships: the formation of endothelial dysfunction, increased free radical oxidation processes, оxidative stress and chronic systemic inflammation exacerbate hypertension and the risk of cardiovascular complications. In this regard, the use of the antihypoxic cytoprotector meldonium, which has an angioprotective effect, seems justified.

Objective - to evaluate the relationship between the degree of bronchial obstruction and the parameters of the daily blood pressure profile in patients with hypertension combined with COPD during complex therapy including meldonium.

Materials and methods. The study included 80 patients aged 35-67 years (48.3±5.1 years) with stage 2 hypertension and myocardial ischemia during intense physical exertion. Of these, 40 cases had hypertension combined with moderate COPD with impaired respiratory function (FER). Patients were randomized into 4 groups based on the presence or absence of COPD and the nature of drug therapy: Group 1 - patients with hypertension without comorbidities who used only traditional therapy (n=20); Group 2 - patients with hypertension + COPD who used only traditional therapy (n=20); Group 3 - patients with hypertension without concomitant diseases who received meldonium in addition to traditional therapy (n=20); Group 4 - patients with hypertension + COPD who received meldonium in addition to traditional therapy (n=20). At inclusion in the study and after 6 months of therapy, the parameters of respiratory function and daily blood pressure profile (DBP) were assessed.

Results. Before the study, the FEV1 values of patients with AH were within the normal range. In patients with AH combined with COPD, the FEV1 parameters characterizing bronchial patency were significantly reduced, indicating the presence of bronchial obstruction.The inclusion of meldonium in complex therapy in a group of patients with hypertension in combination with COPD was accompanied by a significant increase in FEV1, as well as an increase in the FEV1/VC ratio (p<0.05). At baseline, the parameters studied were above normal. By the sixth month of observation, a decrease in PDBP was observed in all groups during therapy. Patients receiving meldonium along with standard therapy demonstrated a more pronounced decrease in PDBP compared to those receiving traditional therapy.

Conclusion. It has been established that the addition of meldonium to standard therapy in patients with hypertension and COPD leads to a more pronounced improvement in bronchial patency, manifested by a significant increase in respiratory function parameters: FEV1 and FEV1/FVC. The use of meldonium in patients with hypertension and COPD during combination therapy is associated with a more pronounced reduction in BP.

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