Metabolic X-syndrome. Purpose of the study: To work out most effective methods of MXS treatment basing on comparative evaluation of various antihypertensive drugs (SPa1 AB, IAPF, ARA ІІ) both at monotherapy and in combina-tion with hypolipidemic therapy.Methods of research: The indices of ACMAP and ECG were studied using 24-hour monitoring of AP and ECG; intracardiac hemodynamics and structural-functional state of the myocardium were evaluated using M-mode EchoCG. Lipid metabolism pa-rameters were determined with enzyme method using automatic analyzer. Blood glucose level was determined with glycosooxi-dant method using a glucometer. Blood IRI level was determined using immunoenzyme assay. Anthropometric examination was done with determining the height, weight, followed by BMI, waist circumference, hip circumference and waist/hip ratio. Theoretical and practical results: The necessity of wide use of ACMAP and ECG with the purpose to reveal individual charac-teristics of circadian AP profile, diagnosis of symptom-free epi-sodes of AP elevation, presence of myocardium ischemia (in-cluding its painless form) and adequate choice of antihyperten-sion drugs was shown. The characteristics of intracardiac hemo-dynamics and functional state of the myocardium in patients with MXS as well as indices of lipid and carbohydrate metabolism in MXS were determined. Optimum schemes of antihypertensive therapy in patients with MXS with the consideration of ACMAP and ECG parameters, peculiarities of intracardiac hemodynamics, structural functional state of the myocardium, lipid and carbohy-drate metabolism were worked out. Significance of ACMAP and ECG in prognosis of target organs involvement and development of complications was determined. Practical significance of the use of not only mean AP parameters but also such parameters of circadian monitoring as pressure load, AP variability (STD), cir-cadian index, time index was shown. Practical significance of the use of AСMECG for control of hypertensive therapy efficacy asto the progress and duration of myocardium ischemia (including its painless form) in MXS patients was shown.Novelty: Peculiarities of clinical manifestations of AH in MXS were determined. More considerable changes of main compo-nents of circadian AP profile in MXS when compared with EH with obesity without insulin resistance were proved. Correlation of ACMAP parameters and indices of lipid, carbohydrate me-tabolism and anthropometric findings of MXS patients were de-termined. It was established that myocardium ischemia (including its painless form) is frequent in patients with MXS, its develop-ment is associated with ACMAP parameters and indices of lipid, carbohydrate metabolism, structural-functional state of the myo-cardium and anthropometric findings. More considerable changes in LV geometry in MXS when compared with EH with obesity without insulin resistance were proved. Characteristics if intra-cardiac hemodynamics and structural functional state of the myo-cardium in MXS and their correlation with ACMAPlipid, car-bohydrate metabolism and anthropometric findings were established. The influence of antihypertensive therapy on ACMAP and ECG parameters, lipid and carbohydrate metabolism both at monotherapy and at combination with hypolipidemic therapy were established. The protocols of MXS treatment which provide not only antihypertensive effect but also improve coronary circulation and metabolic changes were worked out. Application of ciptofibrate in addition to antihypertensive therapy was shown to be accompanied by significant improvement of metabolic parameters. Systemic analysis allowed to determine the character of structural rearrangement in the organism in MXS during antihypertensive therapy.Degree of introduction: The findings of the research are used in the work of Institute of Therapy of Academy of Medical Science of Ukraine (Kharkiv), Kharkiv Medical Academy for Post-graduate Training, Kharkiv City Clinical Hospital No. 8, Lugansk Regional Cardiology Hospital, Lugansk City Hospital No. 1, and in theteaching process at cardiology and functional diagnosis department of Kharkiv Medical Academy for Post-graduate Training (Ministry of Health of Ukraine).Sphere of application: Medicine, cardiology.
