Lozynskyi S. Prediction of the arterial hypertension course and secondary prevention effectiveness in residents of Podillya through the development of the concept of hypertensive heart disease, taking into account the polymorphism of the angiotensin receptor gene of the first type.

836 persons aged 25 years or more (630 hypertensive patients and 206 - the control group) were examined by clinical methods and by methods of echocardiography, ambulatory blood pressure monitoring, applanation tonometry, studying polymorphism of the angiotensin receptor type 1 gene. The additional prognostic meaning of inappropriate left ventricular mass to the blood pressure level has been found. Different methods of measuring blood pressure: office BP, ambulatory BP monitoring, BP self-monitoring, applanation tonometry were explored for the improvement of left venricular mass inappropriateness determining. The analysis of essential hypertension course and routine treatment in residents of Podillya was provided. The role of ATR1 gene polymorphism, heredity of essential hypertension, appropriateness of left ventricular mass to the level of blood pressure and the kind of antihypertensive therapy, was studied based on 5-year follow-up of 132 patients with essential hypertension. In residents of Podillya the influence of genetic factors on the occurrence and course of arterial hypertension was revealed. In particular, the inheritance of hypertensive disease was found to be more likely from mother than from father. It is known as fenomenon of "maternal component in familial aggregation of essential hypertension". Also, the association of C allele in ATR1 gene with higher blood pressure levels was found. It was revealed that only 15% of patients achieved target blood pressure levels in a real medical practice, despite the fact that the achievement of target blood pressure was associated with regression of left ventricular mass. It was found that the results of treatment based on ACE inhibitors or angiotensin receptor antagonists could be improved by taking into account the ATR1 gene polymorphism. The possible benefits could be expressed in better achievement of target BP values and regression of left ventricular mass. The original method of predicting inappropriate left ventricular mass on the basis of EDD and systolic blood pressure was developed. A convenient method of assessing the results of applanation tonometry using a new index, so-called "Vascular Age Index", was proposed. The usefulness of Rautaharju's formulas for the assessment of myocardial mass and its changes during long-term monitoring based on standard ECG data was proved. The advantages of this method over the standard echocardiography in repeated studies were: more widespread use, lower cost, and lower "test-retest" deviation.