Bajbakova Y. Neurohumoral and endothelial factors in the development of hypertensive disease in patients concomitantly having the II type of diabetes mellitus during of antihypertension treatmen

The thesis deals with study of the role of neurohumoral and endothelial factors in the development of hypertensive disease (HD) in patients concomitantly having the II type of diabetes mellitus. It has been revealed that patients of this kind have changes in the neurohumoral mechanisms taking part in BP regulation, and these changes demonstrate prevalence of vasoconstrictive factors: higher levels of endo-thelin-1, thromboxane, angiotensin П. Moxonidine treatment of patients with mild and moderate HD together with concomitant П type of diabetes mellitus is accompanied by a reduction in the systolic and diastolic BP, better indices of lipid and carbohydrate metabolism, a reduced expressiveness of proteinuria, and a higher level of endothelial mediators which cause vasorelaxation. Spirapril treatment of patients with HD and the II type of diabetes mellitus is accompanied by an anti-hypertensive effect. At the same time, a higher concentration of plasma prostacy-clin is observed with a simultaneous decrease in the level of thromboxane and angiotensin II, as well as a reduced expressiveness of proteinuria. Treatment with this drug is accompanied by an improvement in cardiohemodynamic indices. Lacidip-ine treatment is accompanied by a moderate decrease in the systolic and diastolic BP, a reduced rate of angina attacks, an increased tolerance for physical load, a decrease in the total peripheral vascular resisrtence. The drug does not cause any significant changes in the renin-angiotensin-aldosterone system and does not produce a negative effect on the metabolism of carbohydrates and lipids.