Shevchenko M. Role of the endothelium dysfunctions and disturbance of peripheral haemodynamics in hypertensive patients.

Object of the study: hypertension disease. Purpose of the study: To work out diagnostic and therapeutic approaches to management of the patients with hypertension disease basing on the study of endothelial dysfunction parameters and peripheral hemodynamics during treatment with angiotensin II receptor antagonists. Methods of research: To evaluate the functional state of the vascular endothelium as well as to determine blood plasma endothelin-1 level (ET-1), 3'-5'-cyclic guanosin monophosphate, stable metabolites of prostacyclin and thromboxane in the blood plasma, immunoenzyme methods were used. The study of peripheral hemodynamics indices was done using venous occlusive pletismography. Mathematical and statistical methods were used to evaluate significance of deviations. Theoretical and practical results: It was shown that adequate evaluation of severity and clinical course of the disease in HD requires complex evaluation of ET-1 amount in the plasma, prostacyclin and parameters of peripheral hemodynamics. Basing on the data about the level of endothelial vasoactive factors and parameters of peripheral hemodynamics, rec-ommendations about improvement of the efficacy of treatment with the use of Irbesartan, angiotensin II receptor antagonist, were worked out. Novelty: Main regularities of the character of changes of endothelial vasoactive factors and disturbances of peripheral hemodynamics at different stages in patients with HD were established. Correlation between the degree of endothelial vasoactive factors activation and severity of hemodynamic disturbances was proven. Pronounced normalizing effect of Irbesartan, angiotensin II receptor antagonist, on the parameters of endothelial function, tone of the peripheral vessels, and AO system was revealed. Degree of introduction: The findings of the research were introduced into the training process at Zaporizhzhia State Medical University, the work of therapy and cardiology departments of Zaporizhzhia Cardiology Center, City Clinical Hospitals No. 10 (Zaporizhzhia), City Clinical Hospitals No. 8 (Kharkiv). Sphere of application: Medicine, cardiology.