APPROACHES TO COMBINED TREATMENT OF PATIENTS WITH CARDIOPULMONARY PATHOLOGY

Abstract

Treatment and control of hypertension is an important clinical problem, especially in the case of concomitant risk factors and bronchoobstructive diseases. The use of antihypertensive drugs in the patients with bronchoobstructive pathology has certain features. The use of β−blockers for the treatment of hypertension in the patients with cardiopulmonary pathology helps to reduce mortality, the number of visits to the doctor, those to the emergency rooms and exacerbations of chronic obstructive pulmonary disease. Angiotensin II receptor antagonists are the preferred choice for the patients with chronic obstructive pulmonary disease, requiring the treatment with renin−angiotensin−aldosterone inhibitors compared with angiotensin−converting enzyme inhibitors. Statin therapy improves a shortness of breath, reduces exacerbations, hospitalizations and mortality in the patients with cardiopulmonary pathology. The use of anticoagulants and anti−platelet agents in this category of patients helps to reduce the future morbidity and mortality associated with thrombotic diseases. There are no safety concerns or contraindications to the use of calcium channel blockers or aldosterone receptor blockers (including spironolactone) in the patients with cardiopulmonary pathology, but high doses of diuretics should be used with caution. Pulmonary rehabilitation programs, which included either strength training or a combination of general exercise, were effective for both the patients with bronchoobstructive disease and comorbid conditions. However, the indications, components, regimen, and end goals of such programs for "complex patients" with several comorbid conditions that complicate each other are remained poorly understood. Key words: cardiopulmonary comorbidity, drug treatment, physical rehabilitation, hypertension, chronic obstructive pulmonary disease.