Peculiarities of data of 24-hour ECG monitoring and heart rate variability in patients with hypertension associated with chronic obstructive pulmonary disease

We found a high frequency of co-occurrence of arterial hypertension and chronic obstructive pulmonary disease (COPD) in the therapeutic practice of 130 patients.Objective. To investigate daily ECG monitoring results and heart rate variability (HRV) in patients with a combination of hypertension and COPD.Material and Methods. A total of 130 patients with arterial hypertension were examined. The main group (n = 90) consisted of comorbid patients with arterial hypertension suffering of COPD, mean age of 61.3 ± 1.0 years. The comparison group (n = 40) comprised hypertensive patients without COPD, with a mean age of 59.1 ± 1.5 years. All patients received 24-hour ECG monitoring with HRV assessment.Results. Analysis of heart rhythm abnormalities and cardiac conduction disorders allowed to detect the following arrhythmias in patients with hypertension in the presence of COPD: paired supraventricular extrasystoles, runs of supraventricular tachycardia, paroxysmal atrial fibrillation, Lown grade I ventricular extrasystoles, and paired ventricular extrasystoles. The right bundle-branch block was the most frequent conduction disorder observed in patients with COPD. Temporal analysis of HRV showed that the basic daily-average parameters responsible for the overall tone of the autonomic nervous system (SDNN, SDNNi, and SDANN) and the indicators reflecting the effects of parasympathetic regulation on the heart activity (RMSSD, pNN50, and HRVTI) were attenuated in comorbid patients.Conclusion. This study showed that patients with arterial hypertension associated with COPD were more prone to the occurrence of potentially dangerous arrhythmias. Heart rate variability in such patients was characterized by a decrease in the tone of the parasympathetic division of the autonomic nervous system and the predominance of sympathetic effects on cardiac activity.