Object of the study: Patients with essential hypertension engaged in vibration-noise professions. Purpose of the study: To optimize the diagnosis and treatment of essential hypertension in the workers of vibration-noise professions basing on the study of the character of hemodynamic and structural-functional changes of the left ventricle, functional state of the endothelium, activity of lipid peroxidation and antioxidant protection systems. Methods of investigation: Echocardiography and tetrapolar chest rheography were performed. Blood serum amount of endothelin-1 was determined with immunoenzyme method, blood serum NO level was determined using Griss-Ilosvy method, LP-AOP system state was evaluated using spectrophotometry. Theoretical and practical results: Differences in parameters of hemodynamics and structural functional changes in machine-building workers with essential hypertension depending on the conditions of work were determined, which prove the necessity of differentiated therapeutic-preventive measures in various professional groups. In patients with EH of vibration-noise professions, considerable changes of hemodynamics were determined in case of soft arterial hypertension. This allows to conclude about more rapid progress of EH and necessity to consider these changes at solving expertise questions. The character of endothelial and LP-AOP dysfunction was established, which allows to improve the quality of early diagnosis of hemodynamic disturbances. The efficacy of combination with Dilargin anti-hypertension therapy in patients with EH of vibra-tion-noise professions was proved. Novelty: Theoretical ideas about the character and mechanism of development of hemodynamic disorders in EH in workers of harmful professions were validated and expanded. It was proved that harmful occupational factors in EH in workers of vibration-noise professions influenced the structure of hemodynamics and morphofunctional changes of the myocardium. Hypokinetic type of circulation with reduction of inotropic heart function, energy requirements of the myocardium and higher values of total pe-ripheral vascular resistance prevailed. Post-load increases, resis-tance hypertension develops, left ventricle myocardium enlarges, the geometry of the left ventricle changes. High incidence of left ventricle hypertrophy in EH in machine-building workers was re-vealed. Besides left ventricle hypertrophy other changes in the left ventricle geometry develop. In patients with EH of vibration-noise professions concentric types of remodeling prevail. It was proved that hypertonic reconstruction of the heart in EH patients of vi-bration-noise professions increased with the duration of service, age, AH degree. It was determined that cardiodynamic changes in patients of vi-bration-noise professions were accompanied by increased blood plasma endothelin-1 concentration, NO concentration, parameters of lipid peroxidation system and reduction of AOP parameters. It was determined that the degree of endothelial dysfunction de-pended on the level of AO elevation and the character of hyper-tonic reconstruction of the heart. It was shown that combined hy-potensive therapy with Delargin positively influenced the clinical manifestations of the disease, hemodynamic and metabolic changes, improved the psychological profile of the personality. Degree of introduction: The findings of the research were intro-duced into the work of Institute of Therapy (AMS of Ukraine), Kharkiv Research Institute of Occupational Hygiene and Occupa-tional Diseases, therapeutic department of City Hospital No. 4 (Chernovtsy), therapeutic department of City Hospital No. 2 (Dnipropetrovsk), department of occupational diseases of Lviv Regional Clinical Hospital as well as teaching process at the de-partments of therapy, clinical pharmacology and professional dis-eases of Bukovyna State Medical Academy, internal and occupa-tional diseases of Kharkiv State Medical University. Sphere of application: Medicine, cardiology departments.
