Shevchenko O. Hemodynamic and humoral effects second generation ACE-inhibitors at a refractory arterial hypertension

In this work was studied 184 patients with different hypertension, with presence and absence of a resistance to therapy were inspected. It was established, that the refractory arterial hypertension is characterized by increase of common peripheral vascular resistance, reduction of cardiac and stroke indexes, that predetermines structural adapting of heart with development predominantly dilatation variant of hypertrophy of the myocardium. This work has allowed to define hierarchy of the neurohumoral factors of vasoregulation (water-salt exchange, renin-angiotensin system, cyclical nucleotides and kinins) in development of a refractory arterial hypertension. The new data about the mechanism of development of a resistance to therapy with the help of systems analysis were obtained. The analysis of efficiency of combined treatment of patients with essential hypertension with the use of ACE inhibitors, and without them was conducted. In this paper the most effective schemes of treatment of a refractory arterial hypertension were justified. It was shown that during therapy of resistance with the use of ACE-inhibitors, the sexual factor play role.