N.G. Bychkova, S.A. Bychkova, G.A. Taran. Immunological aspects of arterial hypertension combined with chronic obstructive pulmonary disease

The aim – to determine the clinical, functional features and the immune system status in patients with arterial hypertension (AH), combined with chronic obstructive pulmonary disease (COPD).

Material and methods. We examined 87 patients with AH of II stage, average age 53.7±3.4 years, among them 42 patients (I group), with isolated AH, and 45 patients – AH stage II, combined with COPD (group II). The control group consisted of 36 healthy individuals randomized by age and sex, without signs of AH and COPD. All patients underwent echocardiographic examination, lipid profile, determination of the level of pro- and anti-inflammatory cytokines, interferon-γ (IFN-γ), transforming growth factor-β (TGF-β), concentrations of soluble adhesion molecules sICAM-1 and sVCAM-1, content of subpopulations of lymphocytes with phenotypes CD54+, CD11b+, and CD62L+.

Results. In patients with hypertension stage II, disease duration, levels of office SBP and DBP, heart rate, LV MM had no significant differences between groups of patients (Р>0.1). In patients with arterial hypertension combined with COPD, we noted significantly higher values of the body mass index, more prevalence of obesity, concomitant chronic heart failure, and higher (71.1 %) percentage of smokers. In patients with hypertension stage II, associated with COPD, significantly higher levels of TG , LDL and KA were observed. At the same time, HDL levels were lower regardless of the concomitant pathology. Serum concentration of proinflammatory cytokines (TNF-α and IL-1β) in both groups of patients was increased and was dependent on the presence of comorbidity. The increased content of IL-6 and IL-8 was noted, regardless of the presence of comorbidity.

Сonclusions. In patients with arterial hypertension associated with COPD, we revealed more disturbances of lipid metabolism and increased concentration of proinflammatory cytokines in presence of the combined pathology. Increased serum concentration of soluble adhesion molecules combined with higher level of expression of adhesion molecule receptors were revealed in different categories of patients with hypertension.

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