Mikropulo I. Optimizing treatment of elderly patients with essential hypertension depending on the functional state of the liver.

The thesis is dedicated to improving the treatment of essential hypertension in elderly patients with concomitant diffuse liver by determination of the effect of antihypertensive drugs - some ACE inhibitors (lisinopril, ramipril) and Angiotensin II type 1 receptor blocker (valsartan, losartan) with different mechanisms of hepatic metabolism on hemodynamics, functional heart condition, factors cardiovascular risk, cognitive function, functional state of the liver. Comprehensive survey of 146 patients with hypertension aged showed significantly higher prevalence of cardiovascular risk factors and is greater risk of serious cardiovascular events associated with the presence of diffuse liver disease. Established that the purpose of antihypertensive drugs that require hepatic metabolism of ACE inhibitors (ramipril) and Angiotensin II type 1 receptor blocker (losartan) do not differ in their effectiveness of antihypertensive action tolerated by patients and hemodynamic effects of drugs that do not require hepatic metabolism: ACE inhibitor (lisinopril) and Angiotensin II type 1 receptor blocker (valsartan), which makes them equally effective and safe in patients with hypertension in the presence of concomitant diffuse liver disease.