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Diagnosis of the blood pressure (BP) phenotype is the most important indication for its ambulatory measurement because BP phenotype is associated with cardiovascular complications and death. The study of BP phenotypes is important for patients with hypertension (HT) and comorbidity, including asthma and chronic obstructive pulmonary disease (COPD). The combination of HT with these lower airway diseases (LAD) leads to the mutual influence of pathologies creates difficulties in the drugs choice and may affect BP phenotype in HT patients.Aim. To compare in the prospective investigation various characteristics of BP phenotype in HT patients considering LAD (asthma or COPD).Material and methods. The prospective cohort study of ambulatory patients with HT (n=156) was carried out. The part of these patients had asthma or COPD (n=69). The clinical measurements and 24-hour BP monitoring, spirometry, clinical and biochemical blood tests, standard examination were performed, initially and after 12 months. BP phenotype were determined by the ratio of clinical BP and ambulatory BP considering their threshold values. Standard statistical methods and multivariate analysis were used.Results. Patients with LAD had 2 times more often prognostically unfavorable phenotypes: ineffective antihypertensive therapy (AHT) 37.3% vs 15.7% and masked AHT inefficiency 7.5% vs 4.5%; white coat HT on treatment (WCH) and effective AHT were less common(29.9% vs 42.7%; 25.5% vs 37.1%, respectively, p 148 mm Hg (b=2.733, p=0.040), LAD (b=1.015, p=0.011), serum total cholesterol (b=0.350, p=0.043), degree of nighttime diastolic BP decrease (for 13.1-18.0% b=-2.130, p=0.004; for 18.1-24.0% b=-2.509, p=0.001). The factors associated with masked AHT inefficiency in comparison to effective AHT were heart rate in orthostasis >87 beats/min(b=3,512, p=0.006) and SBP in orthostasis 141-148 mm Hg (b=3.405, p=0.004).Conclusion. The prevalence of prognostically unfavorable BP phenotypes (ineffective AHT and masked AHT inefficiency) is two times higher in HT patients with LAD. The first is associated with LAD presence, sex, and serum cholesterol; both phenotypes interrelated with hemodynamic parameters including degree of nighttime diastolic BP decrease. We found no association between AHT and LAD therapy with the BP phenotypes in this study. However, larger works in this area are required, including analysis of outcomes in long-term prospective studies.

Aim. To study the seasonal indicators of quality of life and control of bronchial asthma in hypertensive patients with bronchial asthma, observed by a cardiologist of the state outpatient institution.Material and methods. Data from a prospective cohort study of hypertensive patients, some of which had bronchial asthma without exacerbation, were analyzed. Patients who were observed by a cardiologist at a state outpatient clinic took part in the study. There were other concomitant diseases that occurred in the participants, in addition to hypertension and bronchial asthma. Two groups of patients were formed: the control group (n=85) included patients with hypertension only, the main group (n=40) included hypertension and bronchial asthma. Patients had 3 visits: initial one, and after 6 and 12 months and then data on outcomes (30.1Ѓ}7.6 months of follow-up) were collected. The first and third visits included clinical measurements of blood pressure (BP), 24-hour BP monitoring, spirometry, clinical and biochemical blood tests, a standard survey, survey with questionnaires evaluating the control of bronchial asthma (Asthma Control Questionnaire; ACQ) and the patients quality of life (General Well-Being Questionnaire; GWBQ). The second visit included clinical BP and ACQ and GWBQ questionnaires. A comparison of the average indicators from the total number of observations carried out in winter, spring, summer and autumn periods has been performed.Results. Hypertensive patients with/without bronchial asthma (n=125; 28 men, 97 women, average age 62.6Ѓ}8.8 years, duration of hypertension – 11.6Ѓ}8.6, duration of bronchial asthma – 9.3Ѓ}11.9 years) took part in the study. Outpatient BP levels throughout the study period were maintained at target values in both groups. It was shown that seasonal BP levels do not differ in the compared groups, except for winter indicators: winter daytime systolic BP levels were higher in the main group (p=0.03). Seasonal fluctuations in BP were not detected in the control group, however, they were present in the patients of the main group: winter daytime levels of diastolic BP and average daily levels of diastolic BP and systolic BP were higher than summer ones, and winter daytime systolic BP values (p1.5), in summer and autumn – partially controlled (total score ≤1.5). During the analysis of various factors associated with the combined primary endpoint (death, transient ischemic attack, angina pectoris, cardiac arrhythmias, arterial revascularization), relationships with quality of life indicators were revealed: negative connections – with indicators characterizing positive psychological health, mood at visit, positive correlations – with psychological abilities.Conclusion: Seasonal fluctuations in ambulatory BP levels were not found in the control group and were found in the main group. The quality of life indicators for patients of the main group were significantly worse than in the control group for all components in all seasons. The control of asthma changed in different seasons in accordance with the ACQ total score: uncontrolled bronchial asthma occurred in winter and spring, partially controlled – in summer and autumn. Correlations of the combined primary endpoint with quality of life indicators were found after analyzing various factors.

Aim. To study the rate and characters of masked arterial hypertension (HT) and masked ineffectiveness of HT treatment in industrial workers within annual preventive examination.Material and methods. Workers (n=185) with normal office blood pressure (BP) Results. The rate of masked HT among workers with normal office BP was 10.8%, and masked HT among treated subjects was 34.6%. Workers with masked HT, in contrast to the normotensive workers according to the office BP and ABPM measurements, had a higher left ventricular mass index (in males 129.0±21.2 vs. 109.5±28.8 g/m2, respectively, in women 105.2±43.2 vs. 82.4±25.3 g/m2, respectively, pConclusion. Masked HT and masked HT in treated subjects (masked ineffectiveness of HT treatment) can occur in almost a half of industrial workers with normal office BP. Ambulatory BP measurement methods, especially ABPM, as well as standard risk factors detection are necessary for early revealing of HT phenotypes during preventive examination.