Reznik L. Insulin-like growth factor-1 and peculiarities of cardiovascular remodeling in hypertensive patients with type 2 diabetes mellitus.

Dissertation is dedicated to increasing the efficiency of treatment of hypertensive patients with type 2 diabetes mellitus. We have studied 113 hypertensive patients with type 2 diabetes mellitus and established the basic patterns of changes in blood level of insulin-like growth factor-1 (IGF-1) in patients with essential hypertension depending on the presence or absence of type 2 diabetes mellitus. Based on the research of relationships of these changes with structural and functional characteristics of the left ventricle of the heart and carotid arteries, we revealed the effect of this growth factor on cardiovascular remodeling in hypertensive patients with type 2 diabetes mellitus. We elaborated some criteria of predicting of the type of left ventricular geometry and the nature of the subsequent changes in the level of this growth factor in the blood of this category of patients. Combined therapy of hypertensive patients with type 2 diabetes mellitus that included perindopril, amlodipine, atorvastatin and added to metformine or metformine combined with long acted gliclazide was shown to provide a significant antihypertensive effect, improved carbohydrate and lipid metabolism as well as diastolic left ventricle function and showed the process of cardiovascular remodeling. Adding the long-acting gliclazide to metformin in the background of antihypertensive and lipid-lowering therapy opposed to the use of metformin with gliclazide increases the treatment effectiveness of patients with essential hypertension with type 2 diabetes: result in the significant improvement of left ventricular diastolic function and promotes the preservation of IGF-1 production at the physiological level.