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Clinical and hemodynamic characteristics of arterial hypertension in patients with chronic obstructive pulmonary disease

Authors: Vasilenko A.A.1, Khidirova L.D.1 3, Shpagina L.A.1 2, Shpagin I.S.1 2

Company: 1 Novosibirsk State Medical University, Novosibirsk, Russian Federation
2 City Clinical Hospital No. 2, Novosibirsk, Russian Federation
3 Novosibirsk Regional Clinical Cardiology Dispensary, Novosibirsk, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2025-19-3-352-361

For citation: Vasilenko A.A., Khidirova L.D., Shpagina L.A., Shpagin I.S. Clinical and hemodynamic characteristics of arterial hypertension in patients with chronic obstructive pulmonary disease. Creative Cardiology. 2025; 19 (3): 352–361 (in Russ.). DOI: 10.24022/1997-3187-2025-19-3-352-361

Received / Accepted:  25.04.2025 / 10.06.2025

Keywords: arterial hypertension chronic obstructive pulmonary disease comorbidity



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Abstract

Objective. To determine the effect of the frequency of chronic obstructive pulmonary disease (COPD) exacerbations on clinical and hemodynamic parameters in patients with arterial hypertension (AH).

Material and methods. The observational cohort study included 256 patients with hypertension, including patients with COPD. All patients were divided into 3 groups, 2 of which were the main ones: group 1 – hypertension and COPD without frequent exacerbations (category A and B), n = 101; group 2 – hypertension and COPD with frequent exacerbations (2 or more times per year, category E), n = 103; Group 3 consisted of patients with hypertension without COPD (n = 52). All patients underwent an examination, including the use of clinical, instrumental, and statistical research methods. The analysis of the basic hypertension therapy received by the patient was performed. The general clinical examination included: collection of complaints, anamnesis of life and illness, physical examination, analysis of the frequency of exacerbations and severity of COPD symptoms filling out the MMRs (Modified Medical Research Council Dyspnea Scale) and CAT (COPD Assessment Test), measurement of heart rate, office blood pressure level. All patients underwent echocardiography using the main modes (M, B and Dopplerography). Statistical data processing was performed in the RStudio program.

Results. The median age for the entire cohort was 54 [52; 57] years. An analysis of COPD symptoms using the SAT questionnaire showed that the greatest severity of symptoms was observed in patients with a history of hypertension and frequent exacerbations of COPD – 17.00 [14.00; 20.00] points (p < 0.001). The severity of shortness of breath, according to the mMRC scale, was also higher in patients with COPD and amounted to 2.0 ± 0.05 points in the AH group with frequent exacerbations of COPD and 1.5 ± 0.04 points in the AH group without frequent exacerbations of COPD (p = 0.002). In the 1st and 2nd groups, the diastolic blood pressure values exceeded the values of the AH group (p < 0.001). In group 2, the heart rate was significantly higher compared to groups 1 and 3 (86.00 [81.00; 90.00], 81.00 [77.00; 86.00], 70.50 [66.00; 77.00] beats per minute, respectively; p < 0.001). In the 2nd group, the highest pulmonary artery systolic pressure level was recorded, the median of this indicator was 35.00 [32.00; 39.00] mmHg (p < 0.001), and in the 1st group, the TAPSE indicator was lower – 21.50 [20.50; 22.50] mm (p < 0.001).

Conclusion. The results obtained indicate the formation of a specific clinical and functional phenotype in patients with a comorbid combination of hypertension and COPD with frequent exacerbations, characterized not only by pronounced respiratory symptoms, but also by an increase in hemodynamic load. These features necessitate an individualized approach to the management of this category of patients with a mandatory comprehensive assessment of both cardiovascular and respiratory function. This approach is of key importance in the selection of antihypertensive therapy and monitoring the risk of cardiopulmonary insufficiency.

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About Authors

  • Anna A. Vasilenko, Assistant Professor; ORCID
  • Lyudmila D. Khidirova, Dr. Mrd. Sci., Professor; ORCID
  • Lyubov A. Shpagina, Dr. Med. Sci., Professor; ORCID
  • Ilya S. Shpagin, Dr. Med. Sci., Professor; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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