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Systemic hypertension, left ventricular hypertrophy and myocardial infarction in patients with chronic obstructive
Insights
Patients with chronic obstructive lung disease (COPD) often develop left ventricular hypertrophy and systemic hypertension. These cardiac issues may be linked to hypoxemia and acidosis in chronic bronchitis patients.
Area of Science:
- Cardiology
- Pulmonology
- Internal Medicine
Background:
- Chronic obstructive lung disease (COPD) is associated with significant cardiovascular morbidity.
- Left ventricular hypertrophy (LVH) and systemic hypertension are common comorbidities in COPD patients.
Purpose of the Study:
- To prospectively evaluate left ventricular function in patients with COPD over one year.
- To compare the incidence of LVH and systemic hypertension in COPD patients versus a control group.
Main Methods:
- A prospective controlled clinical study involving 73 COPD patients and 68 matched controls.
- Evaluation of left ventricular function, including hypertrophy and systemic hypertension, over a 1-year period.
Main Results:
- 52% of COPD patients exhibited LVH and 58% had systemic hypertension, compared to 6% and 15% in controls, respectively.
- LVH was more prevalent in chronic bronchitis (70%) than emphysema (19%). Systemic hypertension was observed in 45% of chronic bronchitis patients and 81% of emphysema patients.
- The incidence of myocardial infarction was similar between COPD patients and controls.
Conclusions:
- High frequency of LVH in COPD likely relates to systemic hypertension.
- Systemic hypertension alone does not fully explain LVH in all chronic bronchitis patients.
- Hypoxemia and acidosis appear to play a significant pathogenetic role in LVH development in chronic bronchitis.
Abstract:
Left ventricular function was evaluated prospectively during 1 year in a controlled clinical study of 73 patients with chronic obstructive lung disease. The control group comprised 68 patients matched for age and sex and with no evidence of airways obstruction. Left ventricular hypertrophy was found in 52% and systemic hypertension in 58% of patients in the study group compared with 6% and 15% respectively in the controls. Left ventricular hypertrophy was diagnosed in 70% of patients with chronic bronchitis and in 19% of those with chronic emphysema. Systemic hypertension was observed in 45% of the bronchitic type patients and in 81% of those with emphysema. The incidence of myocardial infarction in the study group was not lower than in the controls. The high frequency of left ventricular hypertrophy in patients with chronic obstructive lung disease can probably be related to a similar high frequency of systemic hypertension. Hypertension per se does not explain left ventricular hypertrophy in all patients with chronic bronchitis, but hypoxemia and acidosis seem to be of pathogenetic importance in these cases.