[Pulmonary hypertension and right ventricular failure. Part V. Therapy in the patients with chronic obstructive pulmonary disease].

In a series of articles the authors discuss literature data concerning epidemiology of pulmonary hypertension, its modern classification; peculiarities of its pathogenesis and treatment in various diseases and conditions. In the fifth lecture they present literature data on nondrug interventions and drug therapy of patients with chronic obstructive pulmonary disease (COPD), complicated with development of chronic cor pulmonale. Contemporary views of the role of oxygen therapy and bronchodilators of various type in treatment of COPD are discussed in detail. Beneficial effect of dihydropyridine calcium antagonists on pulmonary circulation in patients with COPD, possibilities and limitations of their long term use in treatment of pulmonary arterial hypertension including that in patients with COPD are considered. The authors also consider in detail beneficial and harmful properties of drugs, which may be used in treatment of patients with COPD, in particular of digoxin, diuretics, spironolactone, angiotensin converting enzyme inhibitors. Discussion of indications to phlebotomy in patients with COPD and chronic cor pulmonale is presented as well.