Grona N. Clinic and pathogenetic substantiation of correction the deranged synthesis of nitric oxide for nephroprotection in the patients with essential hypertension

The dissertation is devoted to studying of clinical, pathogenetic and therapeutic aspects of features of essential hypertension current with hypertensive nephropathy that are shown by abnormalities of renal hemodynamics and daily rhythm of blood pressure in the patients with endothelial disfunction and decreased endothelial synthesis of nitric oxide. Prescription of Enalapril for hypertensive patients with decreased endothelial synthesis of nitric oxide reduces efferent vascular tone in the kidneys, improves the renal hemodynamics, a daily rhythm of blood pressure and lowers the microalbuminuria. The nephroprotective efficacy of Enalapril is not sufficient for reduction of hypertensives nephropathy in the patients with decreased level of renal blood flow and high efferent renal resistance. Correction of decreased endothelial nitric oxide synthesis by inhibition of renin-angiotensin and sympathetic nervous system activity due to the combined therapy with Enalapril and Nebivolol improves renal hemodynamics and eliminates microalbuminuria.