Dynamics of Clinical Parameters in Arterial Hypertension Patients after COVID-19: Impact of Obstructive Airway Disease (OAD)

Objective — To compare the longitudinal dynamics of clinical parameters in patients with arterial hypertension (AH) according to the presence of obstructive airway disease (OAD) – encompassing asthma, chronic obstructive pulmonary disease (COPD), and pre-COPD – during the year following COVID-19‑related lung damage. Methods — 127 patients with AH were examined during hospitalization for COVID-19‑related lung damage and re‑examined at 3 and 12 months after discharge. The OAD group included 38 patients, while the non-OAD group included 89 patients; the groups were matched for age, gender, BMI, severity of AH, and comorbidities. Results — Non-OAD patients had a higher incidence of stage 3 hypertension. One year after discharge, left-ventricular (LV) relaxation disorders were more frequently detected in the non-OAD group. Right-heart structural and functional parameters also worsened: the right atrial volume index increased (15.0 [12.0; 17.8] mm/m² vs. 16.7 [14.2; 19.5] mm/m², p=0.004); basal right-ventricular width rose (32.2±4.7 mm vs. 33.5±4.7 mm, p=0.007); tricuspid annulus displacement amplitude fell (23.4±2.7 mm vs. 22.4±2.2 mm, p=0.009); and its early diastolic velocity decreased (13.0 [11.0; 15.0] cm/s vs. 12.0 [11.0; 14.0] cm/s, p=0.047). Conclusion — In AH patients, the hospital course of COVID-19-related lung damage did not differ between those with and without OAD. One year after discharge, OAD patients showed a significantly reduced frequency of heart failure with preserved ejection fraction (HFpEF) incidence compared to three months after COVID-19. In non-OAD patients, BMI and the prevalence of stage 3 arterial hypertension increased, LV relaxation disorders were more frequent, and right-heart structural and functional parameters were worse compared with OAD patients.