Synytsia Y. Estimation of the structural and functional state of the cardiovascular system in patients with primary gout in combination with arterial hypertension and its correction

The dissertation was aimed at increasing the effectiveness of treatment of patients with gout in combination with essential hypertension (EH) by optimizing medical therapy. The study included 140 males and divided into three groups. To the first group included 40 patients with EH of the II stage and 2 degrees. The second group of patients consisted of 20 men with primary gout, who had no tophus manifestations and without EH. The third group of the study included 80 males, patients with primary gout without tophus in combination with the EH of the second stage and 2 degrees. Based on the data obtained from the study, it was found that the development of EH in patients with primary gout is characterized by a significantly increased hypertrophy of the heart with increase the index of LV mass by 11,0%, p = 0,03 - than in patients with EH. Also, for patients with a combined pathology of gout and EH, the most common type of LV remodeling is concentrated hypertrophy of the LV (48,8% of cases). For patients with primary gout in combination with EH has frequent of the diastolic disfunction of the LV - 82,5% (with an advantage of type II in 42,5% of cases). The diastolic disfunction of the LV correlates with the index of LV mass (beta = +0,45, p < 0,01) and the duration of gout (beta = +0,31, p < 0,001). For patients with gout and EH, more frequent detection of endothelium dysfunction, when compared with patients with EH or gout (67,5% vs. 47,5% and 35,0%). The main predictors of the violation of vascular motor function of the endothelium in patients with gout with EH are the level of uric acid and the concentration of superoxide dismutase. In patients with hypertension in combination with gout, the addition of quercetin to combined urate lowering and antihypertensive therapy for 6 months contributed to faster and more pronounced achievement of the target level of uric acid (78,8%) and also had an antihypertensive effect without increasing the dose or adding new antihypertensive drugs. In addition to the positive effect on the side of the cardiovascular and excretory systems, there is an improvement in the clinical course of gout.