This dissertation work is devoted to the problem of the prevalence of arterial hypertension, obesity and the combination of these pathologies in school-aged children, as well as the associated decrease in the body's cardiovascular reserves, tolerance to physical exertion, and quality of life. Timely diagnosis, development of therapeutic and preventive measures, detection and correction of complications of obesity and arterial hypertension are an important aspect of modern pediatrics.
The purpose of this work is to optimize prevention measures in school-aged children with hypertension and obesity based on the analysis of clinical and anamnestic, morpho-functional and instrumental data, assessment of quality of life and provision of chromium to the body.
The objectives of the research are as follows:
• To study anthropometric indicators, to determine the peculiarities of the clinical course and to evaluate the quality of life in school-aged children with arterial hypertension and obesity.
• To determine the provision of chromium for children with arterial hypertension and obesity.
• To investigate tolerance to physical exertion in school-aged children with hypertension and obesity.
• To justify preventive measures in school-age children with arterial hypertension and obesity, taking into account the body's supply of chromium, the state of functional reserves of the cardiovascular system, and quality of life.
In the preparatory stage of the study, 542 children aged 7 to 17 took part, who came to the polyclinic for a preventive examination and did not have any complaints about their state of health. The main study was conducted with the participation of 112 children aged 9 to 18 years (52 boys and 60 girls). All children of the main study were divided into four groups. The first group (control) included children with normal blood pressure and body weight (n=35). The second group included patients with confirmed primary stable arterial hypertension and normal body weight (n=39), the third - with normal blood pressure and obesity (n=20), the fourth - with a combination of confirmed primary stable arterial hypertension and obesity (n=18).
The following research methods were used: general clinical (analysis of anamnesis data, assessment of patient complaints, objective examination, anthropometric measurements), instrumental (office blood pressure, daily blood pressure monitor, electrocardiography, ultrasound examination of the organs of the abdominal cavity, kidneys, adrenal glands, thyroid gland, cardiopulmonary testing with exercise using a bicycle ergometer), questionnaires (assessment of quality of life using the Peds QL 4.0 questionnaire, evaluation of certain aspects of lifestyle and general well-being before and after chromium supplementation using questionnaires developed by us), laboratory (general blood test, biochemical blood test, general urinalysis, urine analysis according to Zimnytskyi, x-ray fluorescence examination of the level of chromium in the basal part of the hair), statistical (statistical packages MedStat v5.2 and EZR v1.35).
