Object of the study: hypertension. Purpose of research: optimisation and improvement of diagnostic and treatment of hypertension on the basis of study insulin resistance and markers of non-specific inflammation, and revealing of metabolic and immune effects of beta-blocker bisoprolol. Methods of research: clinical, biochemical, immunoenzyme and instrumental methods were used. Practical value of the received results: obtained data have allowed to increase scientific imagine about influence of insulin resistance and markers of non-specific inflammation on development of hypertension. Hypertensive patients have been recommended to use oral test tolerance to glucose and to calculate insulin sensitivity index as baseline as after test; it significantly increases of specifically define of carbohydrate metabolic disorder. Presence visceral type of obesity unfavourable influence on course of hypertension with forming of hypertrophy type of left ventricular myocardium remodeling. It is necessary to define the levels of CRP and IL-6 during dynamic of observing patients to analyze expression of chronic hemodynamic stress and antihypertensive effect. It has been grounded to use high selectivity beta-blocker in hypertensive patients with insulin resistance and metabolic disorder, and high level of non-specific marker of inflammation. Novelty: Internship between carbohydrate, lipid metabolism, obesity, the degree of hypertension and type of left ventricular myocardium remodeling has been complex observed. Positive correlation between systolic blood pressure and baseline insulin level’s, and negative correlation between systolic blood pressure and insulin sensitivity index before OTTG was estimated. It has been proved association between body mass index and the degree of hypertension, the level of insulin, and insulin sensitivity index as baseline as after OTTG. It is revealed the glucose level’s is higher, and insulin sensitivity index is lower in android type of obesity than in genoid type. That is, obesity, especiallyabdominal, hyperinsulinemia and insulin resistance have general pathogenesis in hypertensive patients. The plasma level of IL-6 and CRP was established in hypertensive patients with insulin resistance. It has been proved the levels of CRP and IL-6 to increase with growing BMI, the levels of blood pressure, triglyceride, general cholesterol, aterogenic coefficient, the level of insulin baseline and after OTTG. It has been shown; that in hypertensive patients with insulin resistance the IL-6 and CRP level’s were higher than in patients with normal insulin sensitivity. The level of non-specific factors of inflammation were higher in hypertensive patients in compare to healthy persons. It has been defined maximal levels of insulin, triglyceride, IL-6 and CRP, BMI in patients with concentrically hypertrophy of left ventricular; and minimal levels of mention factors in patients with eccentrically hypertrophy. It has been proved for the first time high selectivity beta-blocker bisoprolol to decrease IL-6 and CRP level’s; and it has not reliable influence on the levels of insulin, glucose and insulin sensitivity during treatment. Degree of introduction: results of research have been introduced in practical work of medical establishments of Kharkov and region: municipal clinical hospital № 11, № 17, and № 18, Balakleevskaya, Zmiyovskaya and Krasnogradskaya the central regional hospitals, and it have been introduced in studies process in Department of family medicine and general practicing. Sphere of application: medicine, cardiology.
