Д.Ю. Рузанов, Е.И. Давидовская, А.А. Плешко, Е.А. Григоренко, И.В. Буйневич
УО «Гомельский государственный медицинский университет», ГУ «Республиканский научно-практический центр пульмонологии и фтизиатрии», г. Минск, УО «Белорусский государственный медицинский университет»
В публикации представлен краткий обзор наиболее значимых патогенетических и патофизиологических механизмов, которые помогут объяснить феномен коморбидности хронической обструктивной болезни лёгких (ХОБЛ) и кардиоваскулярной патологии, рассмотрены возможности потенциального влияния рекомендуемой терапии ХОБЛ на риски и течение болезней системы кровообращения с позиции доказательной медицины. Показано, что ХОБЛ и сердечно-сосудистые заболевания (ССЗ) имеют единые факторы риска, общие патогенетические механизмы, однонаправленные патофизиологические процессы, схожие клинические симптомы и действуют синергетически в отношении неблагоприятных событий и исходов, что позволяет отнести подобное сочетание к категории коморбидной патологии. Представлены результаты проведенных рандомизированных клинических исследований и метаанализов, продемонстрировавшие, что в настоящее время ни одно руководство по ХОБЛ не содержит детальных клинических рекомендаций по оценке кардиоваскулярного риска у данной категории пациентов, а также недостаточно руководящих указаний по лечению ХОБЛ у пациентов с сердечно-сосудистой патологией или наоборот. С точки зрения международного опыта обосновано, что коморбидная патология ХОБЛ и ССЗ не должна рассматриваться изолировано друг от друга.
ключевые слова: хроническая обструктивная болезнь лёгких, сердечно-сосудистые заболевания, коморбидная патология, кардиоваскулярный риск, биомаркеры системного воспаления, терапия коморбидных состояний

для цитирования: Д.Ю. Рузанов, Е.И. Давидовская, А.А. Плешко, Е.А. Григоренко, И.В. Буйневич. Хроническая обструктивная болезнь легких и сердечно-сосудистые заболевания: патогенетические механизмы коморбидности и фармакологические взаимодействия. Неотложная кардиология и кардиооваскулярные риски, 2020, Т. 4, № 2, С. 1074–1084

Chronic obstructive pulmonary disease and cardiovascular diseases: pathogenetic mechanisms of comorbidity and pharmacological interactions
D.Yu. Ruzanov, E.I. Davidovskaya, A.A. Pleshko, E.A. Grigorenko, I.V. Buynevich
The publication provides a brief overview of the most significant pathogenetic and pathophysiological mechanisms that will explain the phenomenon of comorbidity of chronic obstructive pulmonary disease (COPD) and cardiovascular pathology (CVD). Moreover, in this review is considered the potential impact of the recommended treatment of COPD on the risks and course of cardiovascular diseases from the perspective of evidence-based medicine. It has been shown that COPD and cardiovascular diseases share single risk factors, common pathogenetic mechanisms, unidirectional pathophysiological processes, similar clinical symptoms and effects synergistically with respect to adverse events and outcomes, which allows us to attribute this combination to category of comorbid pathology. The presented results of randomized clinical trials and meta-analyzes demonstrate that currently no COPD guidelines contain detailed clinical recommendations for assessing cardiovascular risk in this category of patients, nor are there enough guidelines for the treatment of COPD in patients with cardiovascular disease or vice versa. In terms of international experience, it is substantiated that the comorbid pathology of COPD and CVD should not be considered isolated from each other.
keywords: chronic obstructive pulmonary disease, cardiovascular diseases, comorbid pathology, cardiovascular risk, biomarkers of systemic inflammation, therapy of comorbid conditions

for references: D.YU. Ruzanov, E.I. Davidovskaya, A.A. Pleshko, E.A. Grigorenko, I.V. Buynevich. Chronic obstructive pulmonary disease and cardiovascular diseases: pathogenetic mechanisms of comorbidity and pharmacological interactions. Neotlozhnaya kardiologiya i kardioovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2020, vol. 4, no. 2, pp. 1074–1084

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