New algorithm for treating patients with combined cardiac and pulmonary pathology implemented by UNN medical researchers

Lobachevsky University medical experts have implemented a new algorithm for the treatment of patients with combined heart and lung pathology, which occurs in at least 16% of Russians. The algorithm is based on the use of third-generation beta-adrenoblockers and calcium antagonists and is already in use at City Clinical Hospital No. 5 in Nizhny Novgorod, Central City Hospital in Arzamas (Nizhny Novgorod region) and other hospitals.

Beta-blockers are widely used to reduce blood pressure and slow down the heart rate, but they can harm the bronchopulmonary system. Researchers at the UNN Institute of Clinical Medicine have found that it is safe to use third-generation beta-blockers in patients with myocardial ischaemia and bronchial asthma.

120 patients with stable angina and bronchial asthma were divided into three therapy groups by Lobachevsky University physicians: the first one was treated with the third generation beta-blocker bisoprolol, the second one with the calcium antagonist verapamil, and the third one with a combination of bisoprolol and amlodipine. The patients in the second and third groups appeared to have the heart rate and blood pressure that were closest to normal.

"Beta-blockers improve longevity and quality of life. However, when cardiologists see a patient with concomitant bronchial asthma, they realise that there are contraindications for these patients. The doctor has to be sure that the risks will be minimal. We have proven that the use of third-generation beta-blockers in patients with mild to moderate bronchial asthma not only reduces angina attacks and increases exercise tolerance, but also has a positive effect on the bronchopulmonary system. Endothelial function improves, and the pressure in the pulmonary artery decreases," explained Professor Natalia Grigoryeva, Acting Director of the UNN Institute of Clinical Medicine.

Lobachevsky University researchers have proposed a special treatment tactic: to assess external respiratory function, stabilise bronchial asthma and start using beta-blockers, gradually increasing the dose of the drug to the maximum effective and safe level.

The results of the study were published in the leading Russian peer-reviewed journal "Cardiology" and were also presented at all-Russian congresses of cardiologists. The algorithm can be incorporated into the arsenal of physicians throughout the country.