Kozlovsky V.I., Kovtun O.M., Dusova T.N., Sobolev S.M., Pecherskaya M.S., Babenkova L.V., Kozlovskaya S.P.
The results of the long-term monitoring of patients with arterial hypertension of the 2nd degree and chronic obstructive pulmonary disease. Focus on antiplatelet agents
Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Vitebsk, Republic of Belarus
Vestnik VGMU. 2015;14(6):32-38.
Abstract.
Clinical examination of 627 patients with arterial hypertension (AH) of the 2nd degree, and chronic obstructive pulmonary disease (COPD) of moderate severity was conducted. 236 patients out of them received conventional antihypertensive and bronchodilator therapy (group 1). In 215 patients to the provided therapy aspirin at the dose of 75 mg per day (group 2) and in 176 cases clopidogrel at the dose of 75 mg per day (group 3) were added.
Results. It has been determined that the risk of the total number of strokes, myocardial infarctions, fatal outcomes within 2 years is 8,4 times (CI 4,38-12,6) higher when the duration of arterial hypertension of the 2nd degree and COPD is more than 10 years, in smokers, in the presence of purulent sputum during exacerbations of COPD.
In the group receiving conventional therapy for arterial hypertension and COPD 10 such significant adverse events as strokes, myocardial infarctions and deaths were registered. In the second group, where aspirin was added - 2, in the third group, where clopidogrel was administered - 1. The use of aspirin and clopidogrel was associated with significant reduction in the number of hospitalizations, emergency calls, visits to the polyclinics, when aspirin was received 1,5 times decrease was observed, in case of clopidogrel - 1,8 times compared to traditional treatment. No reliable differences in the effectiveness of aspirin or clopidogrel were revealed.
Conclusion. Aspirin or clopidogrel administration in patients with arterial hypertension of the 2nd degree and chronic obstructive pulmonary disease of moderate severity is accompanied by a significant reduction in the total number of strokes, myocardial infarctions and fatal outcomes. Aspirin or clopidogrel administration in patients with the duration of arterial hypertension of the 2nd degree and COPD for more than 10 years, in smokers and in the presence of purulent sputum is the most rational.
Key words: arterial hypertension, chronic obstructive pulmonary disease, prediction of strokes, myocardial infarctions, fatal outcomes.
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