Study Reports That Patients with Arterial Hypertension Should be Screened for Pulmonary Diseases

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How To Diagnose Pulmonary Hypertension

A study recently published in the International Journal of Chronic Obstructive Pulmonary Disease emphasized that patients with arterial hypertension can be considered a risk group for chronic obstructive pulmonary disease (COPD) and should be screened for the disorder even in the absence of respiratory symptoms. The study is entitled “Prevalence of chronic obstructive pulmonary disease among patients with systemic arterial hypertension without respiratory symptoms” and was led by researchers at the Federal University of Goiás and Clínica do Aparelho Respiratório (CLARE) in Brazil.

Arterial hypertension is a condition characterized by an abnormal high blood pressure in the arteries. This disorder can compromise the proper functioning of the heart, and be a major risk factor for heart disease, stroke and aortic aneurysm, among others.

It is known that systemic arterial hypertension is a major comorbidity in COPD patients, occurring in more than half of the patients. COPD is one of the most common lung diseases and a major cause of morbidity and mortality worldwide. It is a progressive disease in which individuals develop serious problems in breathing with obstruction of the airways, shortness of breath, cough and acute exacerbations. Smoking is considered to be the leading cause of the disease. COPD early symptoms might be difficult to recognize and the diagnosis is often only made in later stages of the condition.

The prevalence of COPD among patients with arterial hypertension is not clear. In order to address this question, researchers in the present study analyzed a cohort of 316 adult participants aged 40 years or older, with arterial hypertension, tobacco/occupational exposure being treated in three Primary Health Care facilities in Goiania, Brazil. Patients were analyzed through a respiratory questionnaire and spirometry (the most common test to assess lung function). COPD was defined as a value of forced vital capacity and/or forced expiratory volume in 1 second lower than 0.70.

Researchers found that 73.7% of the patients (233) in the cohort reported at least one respiratory symptom, whereas 26.3% of them (83 patients) had no respiratory symptoms. From the arterial hypertension group of patients with respiratory symptoms, 17.6% (41 patients) were diagnosed with COPD, while in the group without respiratory symptoms, 12% (10 patients) were diagnosed with the disorder. In terms of previously undiagnosed COPD prevalence, the team reported that it was higher among patients with no respiratory symptoms (10 out of 10) in comparison to those who had experienced respiratory symptoms (23 out of 41). The team found no correlation between pulmonary function features and blood pressure values.

The research team concluded that irrespective of the presence of respiratory symptoms, individuals aged 40 years or older, with arterial hypertension and tobacco/occupational exposure should perform a spirometry test for the screening and possible diagnosis of COPD. Through this study, researchers hope to emphasize the need for screening high-risk groups for COPD in the earlier stages of the disease.

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Patrícia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.
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