The object of research: resistant essential arterial hypertension and pseudoresistant arterial hypertension. The purpose of the study: to increase the efficiency of treatment of patients with resistant essential arterial hypertension on the basis of optimization of complex antihypertensive therapy in the practice of a family physician. The methods of research: clinical (analysis of complaints, data of anamnesis and objective clinical indicators, levels of office blood pressure, adherence to treatment questionnaires, questionnaires for assessing the quality of life), instrumental (echocardiography, electrocardiography, daily monitoring of blood pressure, home monitoring of blood pressure, office monitoring of blood pressure); laboratory (general analysis of blood and urine, blood creatinine level, lipids, glucose, etc). Scientific novelty of the obtained results. The research conducted has allowed to improve the efficiency of treatment of patients with resistant essential arterial hypertension on the basis of optimization of complex antihypertensive therapy in the practice of a family physician. The previously obtained data on more significant clinical and functional disorders in patients with resistant essential arterial hypertension have been added as compared to patients with pseudoresistant arterial hypertension, has been shown to have a very high total cardiovascular risk. The dissertation research has allowed to develop and scientifically substantiate the new method of differential diagnosis of resistant essential arterial hypertension and pseudoresistant arterial hypertension, which helped to shorten the timing of the appointment of adequate optimal antihypertensive therapy to these patients. The study has confirmed the efficacy of urapidil in the treatment of patients with resistant essential arterial hypertension, which was manifested in a more significant decrease in blood pressure with fewer side effects than the group of patients receiving three drugs at maximum tolerated doses. Previously known data have been supplemented on the positive effects of bisoprolol on blood pressure and clinical progress of resistant essential arterial hypertension, cardiac pain syndrome, cardiac arrhythmias in patients with comorbid cardiovascular pathology. It has been proved for the first time that the determination of individual sensitivity of a patient to antihypertensive therapy (on the example of the determination of sensitivity to bisoprolol, the patent of Ukraine number 89581) allows to optimize complex antihypertensive therapy with resistant essential arterial hypertension, reach the target level of blood pressure, increase the attachment to treatment of patients with fewer side effects. The results of the study for the first time have shown that the use of bisoprolol in complex antihypertensive therapy, to which patients have sensitivity, can achieve almost the same effect on blood pressure in patients with resistant essential arterial hypertension, as well as the addition of urapidil, which is found in the instructions for use as the treatment of resistant essential arterial hypertension. The analysis of remote results of research has allowed for the first time to scientifically substantiate the optimal frequency (4 times a year) of outpatient control of the disease in patients with resistant essential arterial hypertension, which contributes to the preservation of three times more adherence to the treatment of these patients.
