[Peculiarities of the treatment of obstructive pulmonary disease in patients with combined pathology].

Effects of combined drug therapy were evaluated in 97 patients during a year Group 1 comprised 32 patients with chronic obstructive pulmonary disease (COPD), group 2 (n = 34) included patients with COPD and angina of effort, group 3 (n = 31) patients with CHD. Broncholytic therapy was prescribed in compliance with GOLD (2006) recommendations. Patients in groups 2 and 3 continued to receive antianginal therapy started before the onset of the study. Combined therapy included ACE inhibitor enalapril. Positive effect of inpatient treatment of COPD on lung function was transient and subsided with time. Specifically, forced expiratory volume in the 1st second and forced pulmonary vital capacity decreased below the acceptable physiological bounds. BODE index tended to drop too because exercise tolerance increased while dyspnea index by MMRC decreased despite impaired FEV1 and tendency toward a fall in BMI. Echocardiography revealed diminished size of both ventricles and improved left ventricular systolic function. However, heart remodeling progressed with time. Adequate therapy resulted in the reduction of CHD functional class and produced positive antianginal, antihypertensive, and antiarrhythmic effects. The treatment was well tolerated by the patients. It is concluded that combined therapy of COPD including enalapril improves respiratory symptoms and decreases manifestations of concomitant pathology.