Features of the lipid profile of the blood in comorbid patients with chronic obstructive pulmonary disease and arterial hypertension
Summary. Objective — to investigate the lipid profile, its changes, depending on age, body mass index (BMI), smoking and features of chronic obstructive pulmonary disease (COPD) in comorbide patients with COPD and hypertension hypertension (AH). 86 patients were examined. In 1st group there were 44 patients with COPD II—IV stages and AH I–II stages, in 2nd group — 42 patients with AH І–ІІ stages. Methods of research: determination of BMI, blood pressure, smoking status and evaluation of the degree of nicotine dependence, plasma levels of total cholesterol (TC), its fractions, triglycerides. In the 1st group spirography examination (forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and their ratio — FEV1/FVC), evaluation of dyspnea severity by mMRS, frequency of exacerbations during the year were performed. Results and findings. Manifestations of dyslipidemia are more evident in patients with isolated AH than with COPD and AH. With aging in patients with a negative smoking status, the level of proatherogenic indicators of the lipid profile increases both in AH and in COPD and AH patients. Smoking in both groups contributes to the development of dyslipidemia regardless of age. In patients with AH, dyslipidemia mostly has a complex nature (IIb phenotype), and its severity increases with increasing body weight and the level of nicotine addiction. When combined with COPD and AH, dyslipidemia has the nature of hypercholesterolemia (IIa phenotype), it is detected and is an agedepended in patients with BMI >25 kg/m2, its manifestations increase with an increase of bronchoobstuction. In patients with COPD and AH with severe bronchoobstuction, BMI and triglyceride levels decrease. With aging, levels of triglycerides as well as TC, very low-density lipoprotein cholesterol decrease, but there is no decrease in atherogenic coefficient, which indicates the steadiness of proatherogenic ratios of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in this category of patients.
Key words: chronic obstructive pulmonary disease, hypertension, cardiovascular risk factors, dyslipidemia.
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