Terrenkures as an important component of sanatorium-resort treatment of patients with comorbid states in the conditions of the south Crimea coast
Arterial hypertension and chronic obstructive pulmonary disease belong to the group of chronic non-infectious diseases that have common risk factors, such as smoking, age, gender, physical inactivity, obesity and common pathogenetic mechanisms. Objective: To study changes in cardiorespiratory parameters in patients with stage II comorbid hypertension with chronic obstructive pulmonary disease (COPD) after a course of spa treatment in the South Coast of Crimea. Materials and methods. The study included 115 patients, the average age of 53 ± 8.7 years with a diagnosis of Hypertension stage 2. Arterial hypertension 2 degrees. Risk 3. The first group (n=61) included patients with arterial hypertension and COPD, the second group (n=54) - with arterial hypertension and coronary heart disease (CHD). All subjects underwent: echocardiography with tissue dopplerography of the myocardium, spirography, 24-hour blood pressure monitoring. An individual training heart rate (HR) was calculated before carrying out physical exertion (health paths), Results. In comorbid patients with hypertension and COPD, sinus tachycardia with a heart rate of over 80 beats per minute is recorded before spa treatment in 69% cases. According to the daily monitoring of blood pressure, a pathological profile of blood pressure (BP) was revealed, which is characterized by increased average daily, average daytime and average nightly values of blood pressure, insufficient decrease (non-dippers) and an increase in systolic and diastolic blood pressure (night-peakers) at night. biventricular diastolic dysfunction occurs as a «slow relaxation» on echocardiography in 100% of cases. At the end of the spa treatment course, a positive trend was achieved in 39% of patients, which is characterized by a decrease in heart rate to normosystole, an increase in the number of dippers, a decrease in non-dippers, night-peakers, and an improvement in biventricular diastolic filling. Conclusion. In comorbid patients with stage II hypertension and COPD, cardiorespiratory parameters in 69% of cases were characterized by a tendency to sinus tachycardia of more than 90 beats per minute, a violation of the daily blood pressure index with a predominance of non-dippers - 67%, night-peakers -31%, the presence of biventricular diastolic dysfunction like «slow relaxation.» The combination of drug therapy and low-intensity physical activity during spa treatment in the southern coast of Crimea in comorbid patients with stage II hypertension and COPD can achieve a decrease in heart rate of less than 70 beats per minute, increase the number of patients with a normal daily index of systolic BP and diastolic BP by 87.5% improve biventricular diastolic filling in 40% of patients.