Object of the study: arterial hypertension in combination with chronic obstructive bronchitis and bronchial asthma. Purpose of the study: increase of efficiency of treatment in hypertensive patients with chronic obstructive bronchitis and bronchial asthma on the basis of complex estimation of hemodynamic parameters, remodeling of myocardium, analysis of function of external breath, studying of immunological and inflammatory mechanisms. Methods of the investigation: general clinical, laboratory, instrumental, statistical and immunoenzyme. Theoretical and practical results:The diastolic functions parameters of left ventricular were change in the patients with an arterial hypertension (I stage). The progressing of a cardiovascular pathology and development of insufficiency of heart, except diastolic functions parameters change structurally functional and morphological indicators of the left and right parts of heart. The indicators of the right part of heart were change in the hypertensive patients withpulmonary pathologies. The analysis of remodeling of myocardium it has been established, that only at 30 % of patients the normal geometry of heart (the majority of them patients with arterial hypertension, I stage) remains. At progressing of hypertensive illness, joining of insufficiency of heart and pulmonary pathologies there is a change of geometry of heart (as a concentric hypertrophy, concentric remodeling and eccentric hypertrophy). As a result of research of function of external breath change of indicators of bronchial passableness has been established and at the isolated arterial hypertension. At a combination of an arterial hypertension with pulmonary pathology high-speed and capacitor parameters of function of external breath authentically change. As a result the analysis of immuno-logical and inflammatory mechanisms and neurohumoral factors has been established early changes of concentration interleukine-1 and the tumor necrosis factor(in hypertensive patients, I stage). The concentration of cytokines and neurohumoral factors were changed in direct dependence on weight of pathological process. At studying of changes of the specified parameters depending on type of geometry of heart, it has been established, as the patients having normal geometry of heart have authentic changes of concentration of cytokines and neurohumoral factors in comparison with control group (p <0,05). Changes of geometry of heart are accompanied by more considerable changes from concentration of cytokines and neurohumoral factors. At appointment Celiprolol the positive dynamics shown in normalization and an effective control of arterial pressure, improvement diastolic and systolic functions, positive influence on remodeling of myocardium immunological and inflammatory mechanisms and neurohumoral indicators, improvement of ventilating function of lungs. Novelty: It is established, that remodeling of myocardium it is accompanied by change of diastolic functions parameters of left ventricular. These changes occur at the initial stages of development of hypertensive illness; and at joining of insufficiency of heart and pulmonary pathologies are even more considerable. It is proved, that the pulmonary pathology brings the contribution to remodeling of myocardium. In turn, remodeling of heart it is accompanied by deterioration of function of external breath. It is established, that at early stages of development of hypertensive illness in blood whey concentration of interleukine-1, interleukine-6, the tumor necrosis factor increases; thus concentration changes cytokines occur earlier, than remodeling of myocardium. It has been proved, that level of concentration of cytokines correlates with a condition cardiovascular and pulmonary systems, and can be predictor in developments of complications. It is established, that therapy with celiprolol improves diastolic functions parameters, positively influences a condition of function of external breath, immunological and inflammatory processes at patients with the isolated arterial hypertensionand at a combination of an arterial hypertension with chronic obstructive bronchitis and bronchial asthma. Introduction degree: the suggest methods of treatment were introduced in the work of the Kharkov regional student's hospital, city clinical hospital №26, city clinical hospital of №8 of Kharkov. Dissertation materials are used in scientific and pedagogical process on chair of therapy and nephrology of the Kharkov Medical Academy of Postgraduate Education. Application sphere: medicine, therapeutic and cardiologic departments.
