Object of the study: arterial hypertension. Purpose of the study: improvement of the diagnosis efficacy of cardiohemodynamic disorders and development of optimal differential approach to combination therapy of arterial hypertension on the base of immune inflammation and apoptosis parameters assessment. Methods of the investigation: general clinical, immunoenzyme, instrumental and statistical ones. Theoretical and practical results: Elevation of CRP, TNF-?, sTNF-R1, sFasL plasma levels and TNF-?/sTNF-R1 was determined that reflect immunoinflammatory and apoptotic hyperactivation in the patients with AH. Specific dynamics of immunoinflammation and apoptosis distant biomarkers means depend on patient’s age, presence, duration and levels of blood pressure elevation was detected. Relationships between TNF-?, sTNF-R1, sFasL levels and development of left ventricular hypertrophy and dysfunction were shown. Short-term high TNF-? concentration induced adaptive myocardial hypertrophy that allow to supports adequate contractile function in increased load. Long-term TNF-? promotes maladaptive processes, more significant in patients with high cytokine levels. Production duration and level of TNF-?, sTNF-R1 level and combination of these factors can regulate adaptive and/or maladaptive response to hemodynamic stress. Possibility of TNF-induced and Fas-induced apoptosis in hypertensive patients was evaluated. Therapy by candesartan and lacidipine combination caused more significant reducing of plasma CRP, TNF-?, sFasL levels and increasing of endogenous TNF-? inhibitor – sTNF-R1 in the patients with arterial hypertension. Advantage of angiotensin II receptors antagonist – candesartan cilexetil and calcium channels antagonists – lacidipine combination in patients with arterial hypertension with elevated CRP, TNF-?, TNF-?/sTNF-R1, sFasL, left ventricular hypertrophy presence and beta-adrenoblockers – bisoprolol and diuretics – indapamide combination in the patients with clinical manifestation of sympathetic system activation on the base of immune inflammatory and proapoptotic hyperactivation was ground. Novelty: clinical study of immune inflammation and apoptosis role in the pathogenesis of arterial hypertension and efficacy of antihypertensive treatment with angiotensin II receptors antagonists and calcium channels antagonists, angiotensinconvertingenzyme inhibitors and diuretics, beta-adrenoblockers and diuretics combinations on markers of these pathological processes activity were performed. Degree of introduction: the results of the study were introduced in the work of Kharkiv clinics: City Clinical Hospital N11, City Center of Diagnostics and Treatment of Arterial Hypertension, Central Clinical Hospital “Ukrzaliznutsya”, Clinical Multiprofile Hospital N17, City Policlinics N9; Dniprodzerzhinsk City Hospital N5, Zaporozhie Regional Hospital of World War II Invalids and in the pedagogical process of Propedeutics of Internal Medicine Department, General Practice – Family Medicine Department, Hospital Therapy Department of Kharkiv State Medical Universi-ty Sphere of application: medicine, cardiological, therapeutic departments.
