Olenych L. Peculiarities of the course of essential hypertension associated with hypothyroidism and obesity.

The thesis focuses on the theoretical generalization and new solution of the topical issue of internal medicine – enhancement of the efficacy of the diagnostics of hypertension disease (HD) comorbid with hypothyroidism and obesity based on studying the specific clinical features of the course, lipid metabolism and leptin levels, activity of inflammation response syndromes, endogenous intoxication and adaptation, anxiety and depression. The research followed up a cohort of 130 patients with HD, hypothyroidism and obesity in the experimental group and 99 patients in the control groups (43 patients with HD, obesity and preserved thyroid function, 36 patients with hypothyroidism and obesity without HD, 20 patients with HD, hypothyroidism and normal body weight and 20 healthy persons of the corresponding age and gender. New data was obtained on the specific features of mutual aggravation in cases of comorbidity of HD with hypothyroidism and obesity, when a worse control of blood pressure levels was accompanied by left ventricular dilatation with diastolic dysfunction; the advanced hypofunction of the thyroid gland was associated with progressing arterial hypertension, prolonged electrical systole, predisposition to thrombosis, renal dysfunction; increase in the body weight and disturbed lipid metabolism combined with delayed atrioventricular conduction, advanced hypothyroidism and suppressed conversion of free thyroxine into triiodothyronine and insufficient control of hypothyroidism with levothyroxine. The research expanded the scholarly views on the severity of the inflammation response, endogenous intoxication and adaptation for cases of HD comorbid with hypothyroidism and obesity. It was shown that disturbed adaptation processes were clearly associated with progressing arterial hypertension and obesity. It was discovered that in cases of the triple comorbidity, vegetative dysfunction was associated with the development of a depressive syndrome, the advancement of which was accompanied by higher levels of blood pressure and worse control of hypothyroidism.