Object of the study: osteoarthritis in combination with arterial hypertension. Subject of the study: daily blood pressure profile (BP), 24-hour ECG monitoring with determination of cardiac rhythm variability, spontaneous and induced platelet adhesion and aggregation with ADP, collagen and thrombin; morphological analysis of platelets; level of von Willebrand factor; degree of joint damage by Kellgren and Lawrence; 10-year risk of fatal cardiovascular events according to the SCORE scale; the assessment of the standard of living according to the SF-36 questionnaire; the pain level on the VAS, the questionnaire for determining the algofunctional index Lequesne and the WOMAC questionnaire, the effect of treatment with meloxicam and antihypertensive therapy in the composition of lisinopril and amlodipine. Objective: To increase the effectiveness and safety of treatment of patients with osteoarthritis in combination with arterial hypertension based on the study of the functional state and morphological features of platelets and vascular endothelium. Methods of investigation: general clinical examination methods for evaluating the manifestations of OA and AH; biochemical methods (total cholesterol, uric acid, C-reactive protein) for assessing the severity of inflammation and the presence of hypercholesterolemia; laboratory methods: determination of the parameters of the blood coagulation system, optical aggregometry with inducers of ADP aggregation, collagen, thrombin, ristomycin for evaluation of platelet aggregation and level of von Willebrand factor; instrumental methods: daily monitoring of blood pressure for determining the manifestations of AH, daily monitoring of ECG by the Holter method with determination of heart rate variability to exclude cardiac arrhythmias, causing hemodynamic disorders and requiring drug correction, determining the 10-year risk of fatal cardiovascular events on the SCORE scale, for patients with osteoarthritis in addition - questionnaires for assessing the severity of pain (VAS, WOMAC, Lequesne) and quality of life (SF-36), biostatistical methods of evaluation and analysis of learned data. Scientific novelty of the results: In patients with OA in combination with AH, the diagnostic value of the evaluation of platelet function by determining the degree of platelet aggregation and ultrastructural analysis of platelets was proved. The contribution to the solution of the problem of increasing adhesion and aggregation of platelets, coagulation properties of hemostasis in patients with osteoarthritis in combination with arterial hypertension was made. Confirmed data on the association of NSAIDs (meloxicam) with increased platelet aggregation and level of von Willebrand factor in patients with OA in combination with AH. Scientific evidence has been added that patients with osteoarthritis in combination with arterial hypertension have violation of both the coagulation and platelet links of hemostasis. For the first time, the relationship between the characteristics of daily monitoring of arterial pressure and the degree of platelet aggregation with ADP, collagen and thrombin, and also the level of von Willebrand factor were evaluated. There was received scientific data on the ability of combined antihypertensive therapy in the composition of lisinopril and amlodipine to positively influence the coagulation unit of hemostasis, platelet aggregation and vascular endothelial function, as well as the quality of life of patients.
