MO083: Phenotypes of Patients With Combined Hypertension and COPD Depending on Renal Function
Authors: Boiko Olha , Rodionova Viktoriia 
Published: May 2022

BACKGROUND AND AIMS

Chronic kidney disease and hypertension are closely linked to cause and effect. Patients with COPD, in turn, have a 1.61 times higher risk of developing CKD than patients without COPD, after adjusting for clinical risk factors. Comorbidity of hypertension and COPD contributes to a greater decrease in renal function. The aim of this study was to identify the phenotypes of patients with a combined course of hypertension and COPD using cluster analysis.

METHOD

In a one-time study, 32 patients with hypertension and chronic obstructive pulmonary were examined. Patients of three groups underwent general clinical examination, collected complaints, tested on the questionnaires of mMRC and CAT, determined nutritional status by anthropometric study and bioimpedancemetry, conducted daily monitoring of blood pressure and ventilatory function, assessed the functional state of the kidneys by laboratory examination of blood. Statistical methods were used, including cluster analysis, using the "Statistics" program.

RESULTS

During the cluster analysis in patients with combined hypertension and chronic obstructive pulmonary disease, 5 large clusters of clinical and laboratory data of patients were identified.

Cluster 1: male and female patients with COPD and hypertension, middle age 43 (1,2) years, smokers. The average duration of COPD is 10 years, hypertension is 20 years. Results for CAT-9, mMRC: 1, the number of exacerbations of COPD per year: 2. The average content of adipose tissue: 22.7% of muscle tissue: 36%, visceral fat: 9%. BMI: 29.5 kg/m2. FEV1: 49%, GFR: 68 ml/min.

Cluster 2: male and female patients with COPD and hypertension, middle age 61 (1,3) years, smokers. The average duration of COPD is 27.5 years, and hypertension is 20 years. Results for CAT: 13.5, mMRC: 2.5, the number of exacerbations of COPD per year: 1. The average content of adipose tissue: 31.4% of muscle tissue: 30.4%, visceral fat: 17.5%. BMI: 31.3 kg/m2. FEV1: 44%, GFR: 63 mL/min.

Cluster 3: male and female patients with COPD and hypertension, middle age 61 (1,3) years, smokers. The average duration of COPD is 13 years, and hypertension is 5 years. Results for CAT: 12.5, mMRC: 1.5, the number of exacerbations of COPD per year: 1. The average content of adipose tissue: 20.6% of muscle tissue: 34.3%, visceral fat: 7.0%. BMI: 23.9 kg/m2. FEV1: 32%, GFR: 58 ml/min.

Cluster 4: male and female patients with COPD and hypertension, middle age 61 (1,3) years, smokers. The average duration of COPD is 10 years, and hypertension is 20 years. Results for CAT: 9.0, mMRC: 1, the number of exacerbations of COPD per year: 1. The average content of adipose tissue: 41.3% of muscle tissue: 28.6%, visceral fat: 11.0%. BMI: 35.0 kg/m2. FEV1: 80%, GFR: 81 mL/min.

Cluster 5: male and female patients with COPD and hypertension, mean age 58.5 (1.2) years, smokers. The average duration of COPD is 27.5 years, and hypertension is 20 years. Results for CAT: 8.5, mMRC: 1.5, the number of exacerbations of COPD per year: 1.5. The average content of adipose tissue is 36.7% of muscle tissue: 30.5%, visceral fat: 13%. BMI: 30.1 kg/m2. FEV1: 61%, GFR: 77 mL/min.

CONCLUSION

Cluster analysis allows to identify five clusters of patients with combined hypertension and COPD, which can be combined into two phenotypes: with greater bronchial obstruction and lower GFR, and with less bronchial obstruction and greater GFR.