Gar'kavyj P. Effectiveness of essential arterial hypertension treatment with Amlodipine, Metoprolol tartrate or Enalapril maleate in patients with normotensive and hypotensive orthostatic reactions of blood pressure.

Object of the study: arterial hypertension (AH) degrees I-III with normotensive and hypotensive orthostatic reactions of blood pressure (BP). Purpose of the research: an increase of the efficacy of treating AH patients with normotensive and hypotensive orthostatic reactions of BP with Amlodipine, Metoprolol tartrate or Enalapril maleate. Methods of the research: general clinical, instrumental, population, statistical ones. Theoretical and practical results: taking into account the peculiarities of types of orthostatic reactions of BP in AH patients makes it possible to establish the prognosis and assess a risk of the development of end points. The devised recommendations for revealing the types of BP reactions with help of a standard active orthostatic test make it possible to improve the quality and opportuneness of the orthostatic hypotension diagnosis. It is suggested to assess the efficacy of BP therapy both by the control over the systolic and diastolic BP, and their maintenance within the range of unqualified hypotensive orthostatic reactions, thereby improving the quality of AH treatment. The devised recommendations for treating with Amlodipine, Metoprolol tartrate or Enalapril maleate in patients with normotensive, unqualified and qualified hypotensive orthostatic reactions of BP make it possible to increase the efficacy f treatment and establich the prognosis of AH course. Novelty: for the first time, the rates, correlations, diagnostic and prognostic values of normotensive and hypotensive orthostatic reactions of BP in healthy people at a young and old age, as well as in patients with AH, were established. Peculiarities were revealed in the reactions of systolic and diastolic BP, heart rate and indices of cardiac rhythm variability in aged patients with normotensive and unqualified hypotensive orthostatic reactions of BP and qualified orthostatic hypotension during their treatment with Amlodipine, Metoprolol tartrate, Enalapril maleate. Regularities were found out in changes of the life quality index, specific distribution of end points and prognosis of AH treatment depending upon orthostatic reactions of BP and the antihypertensive therapy chosen. An algorithm for finding the most effective and safe antihypertensive drug preparation to treate patients with AH, maintain their BP control and simultaneously prevent the prognostically unfavourable qualified orthostatic hypotension was devised and suggested. Degree of introduction: results of the research were introduced into the practical work of Cardiology Departments Nos 1 and 2 of the Ukrainian Railways Central Hospital in Kharkiv, District Hospital No. 6 of Moscow District of Kharkiv, Lviv Regional State Clinical Medical-Prophylactic Cardiological Centre; they are used in the process of education at the Department of Internal medicine of the Medical faculty of V. N. Karazin Kharkiv National University. Sphere of application: medicine, cardiology.