The objects of the research are patients with essential hypertension. The purpose is to identify particular metabolic natriuretic peptides in patients with arterial hypertension, their role in remodeling of myocardium, arterial and venous vessels and also to develop therapies using inhibitors of angiotensin-converting enzyme. Methods: clinical, ultrasound, biochemical, ELISA, statistical. Novelty: it is for the first time that particularities of metabolism of atrial, brain and C-type natriuretic peptides in patients with essential hypertension were identified; the nature of derangements of metabolism of natriuretic peptides was defined, and factors that affect the metabolism of natriuretic peptides in patients with essential hypertension were discovered; the research shows the role of metabolic disorders of natriuretic peptides in the development of structural and functional remodeling of the left ventricular myocardium, arterial vessels, disorders of functional status of vascular endothelium and venous hemodynamics; the impact of therapy of inhibitor of angiotensin-converting enzyme enalapril on metabolism of natriuretic peptides with essential hypertension was researched; and the opportunity of the inverse development of its malfunctioning was proved. Results: Thesis is devoted to the study of features of natriuretic peptides metabolism in patients with essential hypertension, their role in remodeling of myocardium and arterial and venous vessels, and the possibility of correction of revealed derangements by the treatment with angiotensine-converting enzyme inhibitors. It was defined, that metabolism of natriuretic peptides in hypertensive patients is characterized by the elevation of content of their metabolites in blood plasma. Furthermore, hypertensive patients were characterized by derangement of structural and functional state of myocardium of the left ventricle, arterial and venous vessels, that was revealed by the thickening of left ventricular walls, elevation of myocardial mass, development of hypertrophy of arterial vessels and endothelial dysfunction, and decreasing of venous tone. It was proved, that derangement of metabolism of natriuretic peptides plays significant role in myocardial and vascular remodeling in hypertensive patients, moreover atrial and brain natriuretic peptide metabolism derangement is an important factor in left ventricular myocardium remodeling and systolic dysfunction formation, and the C-type natriuretic peptide metabolism derangement is determinant in vascular remodeling. It was defined, that treatment with angiotensine-converting enzyme inhibitor enalapril facilitates not only reversion of myocardial and vascular remodeling in hypertensive patients, but also reversion of derangements of metabolism of natriuretic peptides. It was implemented in practice and used in therapeutic departments of Dnipropetrovsk Regional Hospital named after I.I. Metchnikov, clinical ambulance association in Dnepropetrovsk, Kiev City Clinical Hospital № 1, Dnepropetrovsk regional diagnostic center, hospital department for handicapped participants of war and fighting events of Zaporizhzhya Regional Hospital, Central City Clinical Hospital № 3 in Donets'k , University Hospital of Donetsk National Medical University named after Gorky by Ministry of Health of Ukraine, regional clinical cardiologic dispensary in Chernivtsy, city clinical multi profile hospital № 25 (Kharkiv), City Clinical Hospital № 8 (Kharkov), Odessa Railway Road Hospital (Odessa), Crimean Republican SRI physical methods of treatment and Balneology named after I.M. Syechenov, City Clinical Hospital № 11 (Dnepropetrovsk), Sumy Oblast Cardiology Dispensary, Cardiology department of Zaporozhye Regional Clinical Hospital. Also, the results of the research were implemented in the educational process in the Vinnitsa National Medical University named after M.I. Pirogov, Zaporozhye and Lugansk State Medical University; Field of using - medical cardiological diagnostic process, therapy offices, teaching process at therapeutic departments of medical educational institutions.
