Circadian blood pressure profile and the state of the autonomic nervous system in elderly patients with chronic obstructive pulmonary disease combined with arterial hypertension

Objective: to study the circadian blood pressure profile, heart rate variability and the state of the autonomic nervous system (ANS) in elderly patients with chronic obstructive pulmonary disease (COPD) in combination with arterial hypertension (AH). A total of 205 individuals were examined. Group 1 consisted of 50-59-year-old patients with COPD in combination with hypertension (n = 26); group 2 included 60-74-year-old individuals with these pathologies (n = 42); group 3 included 75-89-year-old patients with COPD combined with AH (n = 42); group 4 consisted of 60-74-year-old patients with isolated AH (n=35); group 5 consisted of 75-89-year-old patients with this pathology (n = 35); group 6 (control) included 25 60-75-year-old individuals without COPD and AH. Ambulatory blood pressure monitoring, ECG, heart rate variability and ANS studies were performed. Statistical processing of the material was carried out by using statistical software package StatSoftStatistica 6.0 (2000). According to the results of the circadian blood pressure profile in the daytime, the values of average systolic arterial blood pressure in all patients were significantly (p<0.01) higher in comparison with control group. As the age of patients with comorbid pathology increased, all the indicators of the circadian blood pressure profile in the daytime and nighttime were significantly (p<0.001) different from corresponding parameters of the group of patients with isolated AH. The “non-dippers” prevailed in all patient groups. In most individuals with comorbidity, predominance of the activity of the sympathetic part of ANS and reduction in the reactivity of the parasympathetic nervous system were found. In patients of older age with combined pathology, high degrees of the left and right ventricular remodeling were revealed, as well as pronounced changes in the indicators of the circadian blood pressure profile with the predominance of the “non-dipper” type. Reduced reactivity of parasympathetic nervous system and increased activation of sympathetic part of VNS prevailed almost in all patients.

хроническая обструктивная болезнь легких, артериальная гипертензия, chronic obstructive pulmonary disease, arterial hypertension

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