Terletskyi R. Clinical and instrumental characteristics and predicting target organ damage in children with primary hypertension

Dissertation is devoted to optimizing diagnosis and prediction of target organ damage in children with primary hypertension. The paper presents the results of clinical, laboratory, instrumental methods and genetic studies conducted in 145 patients with primary hypertension. Studied the genetic background, and features early disease, daily blood pressure in different clinical groups. Found that the most powerful and independent predictor of the development of primary hypertension in children is single-nucleotide polymorphism of gene MMP9 (1562 C -> T) and exon 7 NOS3 (Glu298 -> Asp). Functional changes in primary hypertension in target organs in the absence of their primary organic pathology. For the first time revealed features of functioning renal parenchyma and status as target organs in children with primary hypertension, manifested infringement filtration and excretory functions, increasing time venous phase renal blood flow and decreased functional activity of the parenchyma with preservation of a functioning number. For the first time studied the features of the structure and blood flow vascular neck as target organs in children with primary hypertension through Doppler and found that the most important is investigation thickness of intima-media, which indicates early remodeling of the vascular wall due to high blood pressure; and the criteria for its evaluation to determine the severity of the disease. Expediency distribution of patients with primary hypertension by the risk of target organ damage in accordance with certain parameters that are set as markers of early injury.