Zhadan A. Comparative evaluation of different regimens of therapy of essential hypertension with diabetic nephropathy.

Object of the study: Arterial hypertension with diabetic nephropathy. Purpose of the study: Optimization of AH and diabetic nephropathy treatment based on comparative comparison of ARB (Valsartan), ACEI (Lisinopril) and alpha 1-adrenoblocker (Doxazocin) on АО level, MAU, hemody-namic and morphometric heart parameters, quality of life, parameters of carbohydrate and lipid metabolism. Methods of research: Clinical, biochemical, instrumental. Hisen questionnaire for somatic complaints was used to evaluate the quality of life. Theoretical and practical results: Dynamic MAU study allows to evaluate a nephroprotective effect of various an-tihypertensive drugs and based on the received data to cor-rect the treatment in patients with AH and type 2 DM with DN when proteinuria is absent. In this case preference should be given to the drugs with not only a marked anti-hypertensive effect but also positively influence the quality of life. To evaluate the quality of life it is necessary to use Hisen questionnaire for somatic complaints. Novelty: Based on comparison of ARB (Valsartan), ACEI (Lisinopril) and alpha 1-adrenoblocker (Doxazocin) on АО level, MAU, hemodynamic and morphometric heart pa-rameters, quality of life, parameters of carbohydrate and lipid metabolism, approaches to optimizing the treatment of patients with stage 1-2 AH accompanied by DN was suggested. For the first time, it was determined that Val-sartan and Lisinopril, in contrast to Doxazocin having similar antihypertensive effect manifest nephroprotective properties after 4-week therapy. Improvement of quality of life after treatment with the studied antihypertensive drags was demonstrated, which was proved by a good response of the patients to the administered therapy. Four-week therapy with Lisinopril and Valsartan does not influence the parameters of carbohydrate and lipid metabolism. In turn, treatment with Lisinopril improved lipid blood spec-trum, in particular reduction of atherogenicity coefficient. It was proven that monotherapy in stage 1-2 AH with the studied drags during 4 weeks allows to achieve the target АО levels in 12,4% of patients, which requires the use of two and more antihypertensive remedies in the consider-able majority of the patients. Degree of introduction: The obtained findings are used in the teaching process at therapy, cardiology, functional di-agnosis departments of Kharkiv Medical Academy for Post-graduate Training. They were introduced to clinical practice of city hospital No. 8, general hospital No. 17, central railway hospital, out-patient hospital No. 9 and 19 (Kharkiv), which is proven by Acts of Introduction. Sphere of application: Medicine, therapy.