[Ischaemic heart disease and hypertension in patients with chronic obstructive pulmonary disease and obstructive sleep apnoea].

Chronic obstructive pulmonary disease (COPD) affects almost 10% of the adult population of our country; obstructive sleep apnoea is increasingly being recognized and concerns, according to accepted criteria, 2-9% of females and 4-24% of men. The greatest mortality in chronic obstructive pulmonary disease is not caused by respiratory failure, but cardiovascular complications, including ischaemic heart disease. Obstructive sleep apnoea in half the cases is complicated by hypertension, often refractory to antihypertensive therapy. The paper discusses the pathogenesis of ischaemic heart disease in patients with COPD with particular attention to the inflammation that occurs in these two diseases. The pathogenesis of hypertension in the course of obstructive sleep apnoea is also presented with particular emphasis on hypoxia and sympathetic stimulation. Prevention of coronary heart disease should be a priority of the procedure in chronic obstructive pulmonary disease. The paper also discusses the treatment of ischaemic heart disease, paying attention to the modification of treatment in patients with chronic obstructive pulmonary disease, and discussing the influence of drugs used in COPD on the progression of ischaemic heart disease. Hypertension in the course of obstructive sleep apnoea is often resistant to therapy despite the use of continuous positive airway pressure devices, and often decrease after the use of aldosterone antagonists. Attention is drawn to the anti-inflammatory action of statins and trials of their use in the prevention of exacerbations of chronic obstructive pulmonary disease.