ADIPONECTIN AND INTRACARDIAC HAEMODYNAMICS STATE IN HYPERTENSIVE OVERWEIGHT PATIENTS

Investigation of adiponectin levels andintracardiac haemodynamic statehas been done in 96 patients divided into two groups (1st group – 64 hypertensive (stage II) overweight patients, medium age 59,0 (48,0–63,0) years; 2-nd group – 32 hypertensive (stage II) patients, medium age 58,0 (53,0–63,0) years, normal weight). Dependences between the left auricle size, blood pressure, and BMI increase, as well as between the left ventricle remodelling character and BMI in the surveyed patients were uncovered. Theconcentric left ventricle hypertrophy observed in the surveyed patients was characterised by normal contractility, leftventricle posteriorwall relative thickness increase, and normal or reduced end-diastolic volume. The blood serum adiponectin level in hypertensive (stage ІІ) overweight patients was significantly (nearly 3 times) lower as compared to the group of hypertensive (stage ІІ) patients who had normal weight. Keywords: adiponectin, arterial hypertension, overweight patients, intracardiachaemodynamics.

THE EFFECTIVENESS OF COMBINATED ANTIHYPERTENSIVE TREATMENT IN PATIENTS WITH ESSENTIAL HYPERTENSION OF THE II-ND STAGE DEPENDING ON THE TYPE OF DAILY BLOOD PRESSURE PROFILE AND THE TYPE OF REMODELLING OF THE LEFT VENTRICLE

The aim: To evaluate the dynamics of structural and functional parameters of the heart, vessels in patients with hypertension of the II-nd stage under the influence of combined antihypertensive treatment depending on the type of the left ventricle remodelling and the profile of blood pressure (BP). Materials and methods: The study involved 110 patients with hypertension of the II-nd stage. The ambulatory blood pressure monitoring, echocardiography and Doppler examination of the shoulder arteries were performed. Initial treatment included bisoprolol, lisinopril, hydrochlorothiazide. With impossibility of BP lowering to the target level, amlodipine has been added. Results: higher levels of BP in the “non-dipper” patients have led to the development of more pronounced changes in the heart and vessels compared with “dipper” patients. Three-component therapy was effective in patients with lower BP. The prescription of amlodipine has been found to be necessary for the majority of “non-dipper” patients and for the minority of “dipper”. Combined therapy effectively controlled the BP at the level of the target and contributed to a decrease in the displays of remodelling of the heart and blood vessels. Conclusions: combined therapy used for 6 months reduces displays of disadaptive heart and vascular remodelling, diastolic, endothelial dysfunction. With the lack of efficacy of the therapy, which includes bisoprolol, lisinopril, hydrochlorothiazide, the adding of amlodipine to it can reach the target level of BP