Samoilova S. Optimization of diagnostics and correction of plasma-platelet hemostasis disoders during hypertension combined with chronic obstructive pulmonary disease.

This thesis is aimed to increasing the diagnostic effectiveness of thrombophilic changes that occur during combination of hypertension with COPD. It is based on determining the effect of COPD on the states of various parts of blood coagulation system and the possibility of correction of these changes by pleotropic effects of angiotensin converting enzyme inhibitors and calcium channel blockers. Obtained data was confirmed increase activity of the final stages of hemocoagulation for patients with a combination of hypertension and COPD, which is linked with the bronchial obstruction severity, in combination with suppression of the anticoagulant and fibrinolytic activity with the highest levels of fibrinolysis inhibition. It was found that functional activity of platelets for patients with combined of hypertension and COPD is increased, especially for cases of severe COPD, manifested by an increase of spontaneous aggregation degree, ADP- and adrenaline- induced platelet aggregation, increased arachidon acid-induced platelet aggregation with significant acceleration of the aggregation process. Influence of ACEi and CCB on the platelet and plasma hemostasis in patients with hypertension and COPD was studied. That help to use these groups of antihypertensive drugs taking into account the nature of changes in the plasma-platelet hemostasis: in the presence of superior activation of the coagulation and suppression of fibrinolysis, positive effects should be expect from the appointment of ACEi, in turn, with increased platelet activity and reduction of anticoagulant potential - from using CCB.