Object of the study: arterial hypertension in women. Purpose of the research: optimization of diagnostics and treatment of arterial hypertension in women on a basis of determination of cardiovascular risk factors, evaluation of disorders of metabolic markers and activity of non-specific inflammation. Methods of the research: clinical, laboratory, instrumental and statistic ones. Theoretical and practical results: the research gives the possibility to broaden existing conceptions on gender peculiarities of diagnostics and clinical course of arterial hypertension. Identified age and gender particularities of prevalence of cardiovascular risk factors in hypertensive women should be used in practical health care service during making gender preventive programs. Assessment of anthropometric data with a calculation of body mass index and waist/hips index shows the leading role of total obesity and intermediate type of adipose tissue distribution in a progress of arterial hypertension and co-existing ischemic heart disease development that results in a determination of a disease prognosis. It was proved the suitability of identification of glucose and lipid metabolism markers, inflammation regulating factors as prognostic markers of atherogenesis, metabolic syndrome progress, formation of a certain type of left ventricle remodeling in hypertensive women irrespective of arterial hypertension degree. Determination of anthropometric and metabolic disorders, disbalance of inflammation regulating factors in hypertensive women being in a postmenopausal period enabled to propose pathogenically grounded schemes of treatment for this cohort of patients. Obtained data could be used by physicians of practical health care service establishments with the purpose of diagnostics and treatment improvement in hypertensive women. Integration of results in the educational process of higher educational establishments has a practical value for a training of future therapeutists, cardiologists and general practitioners - family doctors. Novelty: for the first time it was provided complex research of cardiovascular risk factors, anthropometric data, glucose and lipid metabolism markers, activity of inflammation regulating factors (TNF-?, IL-6, IL-4 and CRP) in hypertensive women. It was showed that realization of hereditary mechanisms in a development and a progress of arterial hypertension is considerably mediated by social and environmental factors among which hypodynamia, psycho-emotional stress, excessive usage salt, smoking and alcoholic beverages take the important place. The dependence of anthropometric data (waist circumference, hips circumference, body mass index and waist/hips index) on sex and blood pressure levels was established: elevation of blood pressure levels in women is associated with obesity and intermediate type of adipose tissue distribution, in men - with excessive weight and android type of adipose tissue distribution. Practically healthy women experienced normal body mass and gynoid type of adipose tissue distribution. It was determined that anthropometric disorders (waist circumference, body mass index and waist/hips index increase) in hypertensive patients are accompanied by formation of prognostically unfavourable models of hypertensive heart: concentric left ventricle hypertrophy in women and eccentric left ventricle hypertrophy in men. It was identified gender distinctions in association between age, body mass and glucose metabolism markers: in women meaningful disorders of glucose metabolism occur at older age and they are expressed weaker compared to men (the most insulin-resistant are men at the age of 40-49 years, significant decrease of insulin tissue sensitivity in women occurs over 50 years). Basal insulin concentration and HOMA index in hypertensive women significantly increase only in a case of obesity occurrence while in hypertensive men - already in a case of excessive body mass but obesity development favours significant insulin resistance progress. It was established the significant association between the highest levels of triglycerides, maximal figures of atherogenesis coefficient, the lowest levels of high density lipoproteins and obesity. It was demonstrated the prognostic value of activity of non-specific inflammation regulating factors in an atherogenesis of hypertensive women. Obtained data showed that development of comorbid ischemic heart disease is accompanied by increase of CRP concentrations and decrease of IL-4 levels. It was defined that menopause in hypertensive women precedes obesity progress, formation of android type of adipose tissue distribution, tendency to deterioration of glucose and lipid metabolism markers and substantial disbalance of inflammation regulating factors as well. For the first time it was grounded pathogenically administration of antihypertensive drugs combinations (inhibitor of angiotensin converting enzyme with diuretic and inhibitor of angiotensin converting enzyme with imidazoline receptors agonist) in hypertensive women on a background of age-related hormonal and metabolic disorders.Scientific novelty is approved by 2 Declarative patents of Ukraine for useful model.Degree of introduction: results of research were introduced in practical work of medical establishments of the city of Kharkiv and its region: municipal clinical hospitals № 11 and № 13 of the city of Kharkiv, Scientific-Practical Medical Center "Specialized Medical Department" of the city of Kharkiv, Scientific-practical Center of Obstetrics, Gynecology and Transplantology of the city of Kharkiv, Chuguiv, Kupyansk and Izyum Central Regional Hospitals and Multisectoral Clinical Hospital № 4 of the city of Dniepropetrovsk. Sphere of application: medicine, cardiology.
