Kocherzhat O. Optimization of antihypertensive therapy with the inclusion of statin in hypertensives with metabolic syndrome

Object of study - arterial hypertension and metabolic syndrome. Purpose - to improve treatment of hypertensives combined with metabolic syndrome based on the study of clinical and pathogenetic features of arterial hypertension, the functional state of the liver, insulin resistance and justify the feasibility of lercanidipine / amlodipine and candesartan in combination with atorvastatin. An examination of 139 hypertensives with metabolic syndrome revealed that the disease depends on plasma endogenous insulin level and is more severe in the case of spontaneous hyperinsulinemia and nonalcoholic steatohepatitis. First studied clinical and pathogenetic peculiarities of metabolic syndrome and arterial hypertension in the relation with functional state of the liver and according to the plasma endogenous insulin level. It was found that hypertensives with metabolic syndrome are characterized by: unfavorable daily profile "non-dipper", pathological types of myocardial remodeling, abdominal obesity with signs of insulin resistance and dyslipidemia. These signs are more higher in the case of spontaneous hyperinsulinemia. First given clinical and pathogenetic rationale of inclusion of atorvastatin in the complex antihypertensive treatment with candesartan and lercanidipine in hypertensives with metabolic syndrome and nonalcoholic steatohepatitis. It was proved that using of this complex effectively reduce insulin resistance degree, normalize carbohydrate metabolism, reduce dyslipidemia and intensity of systemic inflammation, improves blood lipid spectrum and functional state of the liver. The results are put into practice of medical institutions, scientific and educational process. Industry - medicine.