Bondar M. Improving the diagnosis and comprehensive treatment of osteoarthritis associated with hypertension

Object of research: osteoarthritis of the knee joints of the I-II stage in combination with GC of the II stage of the 2nd-3rd degree. Purpose: to increase the effectiveness of diagnosis and develop pathogenetically sound therapy of patients in the practice of a family doctor based on the assessment of the clinical course of osteoarthritis with hypertension, study of structural and functional heart condition, circadian blood pressure, commitment to treatment and quality of life. Research methods: general clinical, laboratory (general blood test, general urine test, blood glucose, ALT, AST, total bilirubin, total protein, creatinine, blood lipid spectrum, PSA), anthropometric, instrumental (radiological, electrocardiography (ECG) Echo-CS), daily monitoring of blood pressure (DMAT), medical and social (with the help of questionnaires), statistical. Scientific novelty of the obtained results. For the first time the clinical and laboratory features of disorders of the functional state of the knee joints in the conditions of a combination of osteoarthritis and hypertension are specified in the work. The scientific database on the assessment of circadian rhythm of daily monitoring of blood pressure, structural and functional state of the heart, systemic, intracardiac hemodynamics, and their changes under the influence of treatment in the combined course of OA and GC taking into account the insomnia factor has been supplemented New data on changes in blood lipid spectrum, a marker of systemic inflammatory response to PSA, in the combined course of osteoarthritis with hypertension. Scientific ideas on the stratification of cardiac risk factors and in the practice of a family doctor.For the first time, scientifically substantiated, developed therapy with the inclusion of selective nonsteroidal anti-inflammatory drug meloxicam, a fixed combination of antihypertensive drugs valsartan and amlodipine with additional use of melatonin and evaluated its clinical efficacy and safety in patients with osteoarthritis and hyperarthrosis. The positive effect of the proposed treatment regimen with the inclusion of melatonin on the quality of sleep, circadian rhythm of blood pressure, functional state of the joints, as well as adherence to treatment and quality of life (QOL) in patients with OA with GC.