The article deals with the problem of peripheral hemodynamics adjustment to the systemic and pulmonary circulation, circadian blood pressure (BP) profiles and respiratory ventilation in patients with stage 2 hypertension, complicated by obstructive pulmonary disease, with the use of L-arginine that is exogenous source of nitric oxide. Materials and methods. We observed 100 patients with stage 2 hypertension (the 2nd and 3rd degree) including 80 patients with hypertension, complicated by stage 2 pulmonary hypertension of bronchopulmonary origin, and 20 patients with essential hypertension with identical stage and degree at the age of 56.5±4.12. Results. It was observed that chronic obstructive disease complicates the course of hypertension by peripheral hemodynamics deterioration and increases in systolic blood pressure in the pulmonary circulation leading to cardiac remodeling. A number of positive effects of L-arginine used in combination therapy in patients with arterial and pulmonary hypertension was established. They included the hypotensive effect of hemodynamic preparations, decreased number of patients with a night –peaker and non-dipper profiles, improved ventilation and gas exchange, index Tifno value increasing and reducing pulmonary hypertension. Conclusions. L-arginine, used in combination therapy in patients with hypertension accompanied by chronic obstructive disease, induces potentiation of antihypertensive therapy, improvement of bronchial patency and normalization of circadian blood pressure profiles.
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