Effect of L-arginine on Blood Pressure Profile and Bronchial Patency in Patients with Hypertension Complicated by Pulmonary Hypertension of Bronchopulmonary Origin

I. H. Kupnovytska, L. A. Dron

Abstract


The article deals with the problem of peripheral hemodynamics adjustment to the systemic and pulmonary circulation, circadian blood pressure (BP) profiles and respiratory ventilation in patients with stage 2 hypertension, complicated by obstructive pulmonary disease, with the use of L-arginine that is exogenous source of nitric oxide. Materials and methods. We observed 100 patients with stage 2 hypertension (the 2nd and 3rd degree) including 80 patients with hypertension, complicated by stage 2 pulmonary hypertension of bronchopulmonary origin, and 20 patients with essential hypertension with identical stage and degree at the age of 56.5±4.12. Results. It was observed that chronic obstructive disease complicates the course of hypertension by peripheral hemodynamics deterioration and increases in systolic blood pressure in the pulmonary circulation leading to cardiac remodeling. A number of positive effects of L-arginine used in combination therapy in patients with arterial and pulmonary hypertension was established. They included the hypotensive effect of hemodynamic preparations, decreased number of patients with a night –peaker and non-dipper profiles, improved ventilation and gas exchange, index Tifno value increasing and reducing pulmonary hypertension. Conclusions. L-arginine, used in combination therapy in patients with hypertension accompanied by chronic obstructive disease, induces potentiation of antihypertensive therapy, improvement of bronchial patency and normalization of circadian blood pressure profiles.


Keywords


hypertension; chronic obstructive pulmonary disease; pulmonary hypertension; L-arginine; therapy

Full Text:

PDF

References


Bychkova S. A. Use of antihypertensive drugs in patients with chronic obstructive pulmonary disease related to pulmonary hypertension. Naukovyi Visnyk of NMU im. O. O. Bohomoltsia. 2009; 81-83.

Voronkov L. G. Chronic heart failure and chronic obstructive pulmonary disease. Sertseva nedostatnist. 2010; 1: 12-19.

Zadionchenko V. S. Arterial hypertension in chronic obstructive pulmonary disease M. Anakharsis, 2005; 176.

Zadionchenko V. S., Adasheva T. V., Shilova Ye. V. Clinical and functional features of arterial hypertension in patients with chronic obstructive pulmonary disease. K. Kardiologiya. 2004; 9: 535.

Chazova I. Ye. Arterial hypertension and chronic obstructive lung disease. Consilium medicum. 2006; 8 (2).

Curkendall S.M., Deluise C., Jones J.K. Cardiovascular disease in patients with chronic obstructive pulmonary disease. Epidemiology. 2006; 16: 63–70.

Galie N., Hoeper M.M., Humbert M. Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2009; 34: 12-19.

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (revised 2011). www.goldcopd.com.

García-Olmos L., Alberquilla A., Ayala V. Comorbidity in patients with chronic obstructive pulmonary disease in family practice: across sectional study. BMC Fam Pract. 2013; 14: 11.

Mancia G., De Backer G., Dominiczak A. 2007 Guidelines for the Management of Arterial Hypertension. The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of European Society of Cardiology (ESC). J Hypertens. 2007; 25: 1105–1187.

Mannino D.M., Buist S.A. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007; 370: 765–773.

Sin D.D. Is COPD really a cardiovascular disease? Chest. 2009; 136: 329–330.

Torres J.P. C-reactive protein levels and clinically important predictive outcomes in stable COPD patients. Eur. Respir. J. 2006; 27(5): 902–907.

ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur. Heart J. 2013; 3-72.




Copyright (c) 2017 I. H. Kupnovytska, L. A. Dron

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


IFNMU Logo

Free counters!