Berkelieva M. Peculiarities of essential hypertension pathogenesis and treatment in the conditions of hot climate.

Object of the study: essential hypertension. Purpose of the study: To improve the efficacy of therapy of patients with essential hypertension residing in the conditions of hot climate basing on pathogenetically validated application of drugs. Methods of research: All patients were performed generally accepted clinical laboratory studies. To investigate the morphofunctional parameters of the heart B- and M-mode echocardiography was used. Kalikrein and kalikreinogen activity was studied with spectrophotometry, renin activity and aldosterone concentration were determined with radioimmine assays. Theoretical and practical results: Methods of essential hypertension treatment in the conditions of hot climate were improved using substantiation of application combined therapy with angiotensin II receptor blockers and ACE inhibitors as first-choice drugs. The revealed correlations between clinical, hemodynamic and neurohumoral parameters allow to evaluate the long-term prognosis of the course and possible complications of essential hypertension. Effective therapeutic approaches to treatment of essential hypertension in the conditions of hot climate which are aimed at achievement of the target level of arterial pressure and improve quality of life of the patients were worked out. Novelty: For the first time, the entire picture of participation of vasoactive factors in regulation of arterial pressure in hypertension patients in the conditions of arid zone was presented. The regularities of changes in the humoral factors which determine the pathogenetic characteristics of EH ant its crises in the conditions of hot climate were determined. The role of kinin system in healthy organism adaptation to a hot climate in low geographical latitudes was proven. Neurohumoral basis of development of climate-dependent arterial hypotension with weakened mechanism of evaporative cooling of the organism and disturbed synergism of thermoregulation and autoregulation of the blood circulation in the arid zone were presented. Hemodynamic and biochemical discrepancies in essential hypertension in summer and winter periods and dependence of development of severe hypertension complications in elderly pa-tients from inhibition of the blood depressive system were de-termined. For the first time, it was established that high concentration of aldosterone at CCBS insufficiency is an important pathogenetic factor of crises development in the low-renin group of patients in summer peiod in the arid zone. Correlation between the degree of left ventricle hypertrophy and RAS was revealed. Optimum combinations of antihypertensive drugs were described. Degree of introduction: The results of the work were in-troduced to the clinical practice of therapy and cardiology depart-ments of Ashgabad (Turkmenistan): Therapeutic-Consultative Center of Turkmenistan and Ashgabad Central Clinical Hospital, which is confirmed by certificates of introduction. Sphere of application: Medicine, cardiology.