Kazantseva T. Metabolic interferences and structural-functional changes associated with diabetes mellitus of type 2 and obesity, and of the heart in patients, suffering from essential hypertension ways of their correction

The dissertation paper deals with a study of metabolic changes, the structural-functional condition of the myocardium in patients, suffering from essential hypertension (EH) with manifestations of metabolic syndrome and updating treatment based on ascertaining the metabolic and cardioprotective effects of the angiotensin-converting enzyme inhibitors (enalapril) and agonists of imidazoline receptors (moxonidine) both in monotherapy and combined with hypoxic-hypercapnic trainings (HHT). Impaired glucose tolerance has been established in 10% and hyperinsulinemia on an empty stomach in 13% of the patients with EH without obesity, in patients with EH with obesity – respectively in 25% and 34%. Myocardial hypertrophy of the left ventricle in EH has been found to progress in the presence of insulin resistance (IR) and obesity and has been detected only in 16,7% of the patients without the presence of IR and in 61,3% - with IR. The metabolic and cardioprotective effects of enalapril and moxonidine have provedto be positive. The advantage of combined therapy (antihypertensive therapy + HHT) in EH patients with concomitant diabetes mellitus of type 2 over traditional antihypertensive therapy has been demonstrated in the form of an essential improvement of the indices of carbohydrate and lipid metabolisms.