Object of the study: arterial hypertension with obesity. Purpose of the study: optimization of endothelial functional state diagnostic and improvement of the treatment of patients with arterial hypertension and obesity. Methods of the investigation: physical, general clinical, instrumental, biochemical, immunoenzyme. Theoretical and practical results: the peculiarities of haemodynamic factors, forming endothelial dysfunction were observed. Depressive haemostas link, vasodilatative vessels answer and dysfunctional nitric oxide system state dependences were determined in patients with arterial hypertension and obesity. It was showed, that dysfunction in the nitric oxide system is heterogenic and displayed as decrease of stabile metabolites plasmatic levels or inadequate it increase comparable to healthy persons. It was stated that consequence of decrease endothelial vasodilatative factor synthesis that displayed in endothelial nitric oxide synthase, nitrates/nitrites decreasing was arterial pressure increasing, pathological and paradoxal en-dothelial reaction revealing during reactive hyperemia probe. In-crease nitrates/nitrites plasmatic levels higher than physiological cant been considered as compensator factor, but as negative staining in vessels structure and function by means of involve-ment in process of hypertrophy. Endothelin-1 activation was de-termined especially in patients with arterial hypertension and obesity of 3 stage. This significant factor shows vasoconstrictors participation in pathogenesis of arterial hypertension and vaso-constriction, structural reorganization associated with. was de-tected estimation reasonability of endothelial and inducible nitric oxide synthases, metabolites, endothelin-1 levels as factors that indicate pathogenetic principles of structural and functional ves-sel changes on molecular level in patients with arterial hyperten-sion and obesity. Estimation of vasoactive nitric oxide pool activ-ity, antioxidant system, vasodilatative vessel answer peculiarities could been used as extra diagnostic criteria of clinical course, as-sist to adequate treatment with individual patient peculiarities. Novelty: endothelial functional state was studied: vasoconstric-tive (endothelin-1) and vasodilatative (nitric oxide synthases and metabolities, endothelial-dependent endothelial-independent vasodilatation) arterial regulation tone links, oxidative stress and vascular remodeling presentations in patients with arterial hyper-tension with obesity. Correlation analysis of vasoactive nitric ox-ide pool, endothelin-1 levels, antioxidant system activity, and endothelial-dependent, endothelial-independent vasodilatation was providing. Obesity as a factor of endothelial dysfunction forming was proved. It presented by depression of nitric oxide synthase activity, nitrates and nitrites plasma levels decrease, in-ducible nitric oxide activity expression, S-nitrosotiols and endo-thelin-1 increase. Obesity was considered as a main factor of elastic arteries remodeling acceleration that was confirmed by in-creased intimae-media complexes, decreased diameter and vol-ume blood speed loss. Degree of introduction: the suggested methods of diagnosis were introduced in the work of the Kharkiv Regional Clinical Hospital, Kharkiv City Clinical Hospital №11 they are in use in the pedagogical process and practical work of the Department of Internal Medicine №1 of Kharkiv National Medical University. Sphere of application: medicine, therapeutic and cardiologic departments.
