Dotsenko S. Remodeling and functional state of arteries and left ventricle in hypertensive patients: prognostic aspects and treatment

The dissertation deals with the characteristics of subclinical arterial and left ventricle lesions with ineffective control of arterial hypertension,clarify their impact on the blood pressure daily profile, venous hemodynamics, changes in heart rate variability and humoral factors, clarifying criteria for forecasting the development and substantiation of optimal schemes in combination antihypertensive therapy. It was proved that in patients with uncontrolled hypertension observed a significant increase in subclinical cardiovascular markers of adverse vascular events, which significantly reduces survival without cardiovascular events.It was proved in this patients negative impact of structural and functional vascular disorders in the increasing of daily systolic and pulse blood pressure, their variability and "non-diper" and "night - peaker" profiles, the oppression of heart rate variability.It was determined muscular vessel dysfunction,as a loss of autonomy of blood flow autoregulation,are based on endothelial dysfunction, increased stiffness,lower compliance and hypertrophy of vascular wall.It was proved that impaired blood flow autoregulation reduce survival of patients with arterial remodeling. It was found relationship between markers remodeling of arteries and left ventricle with natriuretic peptides levels.Antihypertensive efficacy with a reverse of arteries and left ventricle subclinical lesions after 24-weeks combinative treatment: for resistant hypertension - 3-drugs combination with losartan, amlodipine and indapamide; for uncontrolled hypertension - 2-drugs combination with losartan plus indapamide or amlodipine plus indapamide.