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Background. Essential hypertension (EH) is a complex, multifactorial and polygenic disease. Despite effective measures for control and modification of traditional risk factors, a significant amount of risk remains. The aim of the study was to evaluate changes in clinical parameters and to analyze the relationship of cholecalciferol, parathyroid hormone with anthropometric, metabolic parameters in patients with EH. Materials and methods. One hundred subjects with EH and target organ damage (stage 2), moderate, high, very high cardiovascular risk were enrolled in case-control study. Control group consisted of 60 healthy subjects matched for sex and age. Pearson’s test was used to determine the relationship between parameters in case of categorical variables; analysis of variance (ANOVA) when one of the variables is categorical and the other is numerical (interval); non-parametric Kruskal-Wallis test in case of abnormal array distribution. Results. Development and course of EH is characterized by clinical, hemodynamic, metabolic abnormalities that are nonlinearly exacerbated with the severity of hypertension. Correlation analysis showed a direct relationship between body weight and waist-to-hip ratio (r = 0.76–0.88; р

The aim was to study the prevalence of sustained arterial hypotension in high cardiovascular risk patients with II–III stage essential hypertension and associated factors. Materials and methods. Patients with II–II stage essential hypertension and sinus rhythm (n = 179, mean age 61 (95 % CI: 59.6‒62.5) years, 57.0 % were males) underwent ambulatory blood pressure monitoring (ABPM). Arterial hypotension episodes were evaluated according to the blood pressure (BP) office measurement (

The aim of the study was to evaluate the effect of type 2 diabetes mellitus (T2DM) and obesity influence on the left ventricular (LV) remodeling peculiarities in hypertensive patients. Materials and methods. In total, 327 patients, aged 38–74 years, were comprehensively examined. The enrolled patients were divided into 4 groups in dependence of the presence of associated disease: the 1st group – n = 87 hypertensive patients with T2DM combined with obesity, the 2nd group – n = 71 hypertensive patient with T2DM and the 3rd group – n = 65 hypertensive patients with obesity; the comparison group consisted of 74 patients with essential hypertension (EH) but without obesity or diabetes. Echocardiography was performed according to the standard method of H. Feigenbaum to estimate the LV parameters. HbA1c was determined by turbidimetric method. Serum glucose levels were determined by ELISA. Results. When comparing the three patient groups with those who had only EH, the most significant influence was found in combined influence of T2DM and obesity on the development of unfavorable type of LV remodeling with values of χ2 = 29.371 and Pearson's contingency coefficient (C) ‒ 0.393 (P < 0.05). The presence of concomitant T2DM without obesity had a significant moderate relationship with the development of unfavorable LV geometry, χ2 = 11.029 and C ‒ 0.266 (P < 0.05), which indicates a much smaller impact on the process compared to the polymorbid effect of T2DM with obesity. Comparison of patients with a combination of EH and obesity with those who had only EH did not show a significant effect of concomitant obesity on the development of unfavorable types of LV geometry with values of χ2 and C: 0.529 and 0.062, respectively (P > 0.05). Conclusions. Essential hypertension with type 2 diabetes mellitus and obesity polymorbidity, but not in combination with type 2 diabetes mellitus or obesity alone, has the most significant association with hypertrophic types of LV remodeling. The co-existence of type 2 diabetes mellitus and obesity in hypertensive patients leads to the development of predominantly LV concentric hypertrophy

The aim of the work is to investigate the diagnostic informativeness of brain natriuretic peptide (BNP) in men with left ventricular (LV) diastolic dysfunction (DD) and initial stages of chronic heart failure (CHF) in comorbid stage 2 essential hypertension (EH 2) and type 2 diabetes mellitus (T2DM). Materials and methods. We examined 211 men. 79 people without signs of cardiovascular disease were assigned to a control group. 62 patients with EH 2 and CHF no higher than NYHA functional class (FC) I were included in the 1st, and 70 men with EH 2 combined with T2DM and CHF FC I–II formed the 2nd main study group. The plasma concentration of BNP was measured by ELISA. The examination included the determination of HbA1c, blood lipid profile, echocardiography. The mathematical processing was performed using the standard statistical package Statistica 6.1. Results. Plasma levels of BNP in comorbid EH 2 and T2DM were significantly higher (102.18 ± 4.18 pg/ml) than those in patients with EH without T2DM (77.40 ± 2.85 pg/ml) and in subjects without cardiovascular diseases (21.74 ± 0.59 pg/ml) (P < 0.00001). According to the regression analysis, the level of BNP was associated with changes in parameters of intracardiac hemodynamics in patients with EH2. In patients with comorbid EH 2 and T2DM, the level of BNP was also associated with indicators of systemic hemodynamics and body weight. BNP as a marker of CHF at the recommended borderline level (35 pg/ml) in patients with EH 2 and T2DM was characterized by a sensitivity of 98.57 % and specificity of 55.32 %. The BNP borderline levels with higher specificity were determined for early diagnosis of CHF in EH 2 with T2DM and obesity comorbidities. Conclusions. BNP, as an early marker of LV DD and the initial stages of CHF at the recommended borderline level in men with comorbid EH 2 and T2DM does not have sufficiently high specificity. In these pathological conditions, the determined borderline levels of BNP can be used as indicative surrogate markers for early diagnosis of CHF during screening with the view to identify persons for further echocardiographic additional examination and in cases where echocardiography is not possible.

Aim. To reveal the relationship between apolipoprotein E gene polymorphism and lipid spectrum modification in patients with essential hypertension. Materials and methods. The lipid spectrum components and apolipoprotein E gene polymorphism were analyzed in 310 patients with essential hypertension. Results. The mean plasma levels of total cholesterol, high and low density lipoproteins, triglycerides and the atherogenic index were 5.18 ± 0.08 mmol/l, 1.32 ± 0.03 mmol/l, 3.06 ± 0.07 mmol/l, 1.74 ± 0.05 mmol/l and 3.21 ± 0.08, respectively. In patients with essential hypertension, the genetic polymorphism of apolipoprotein E was characterized by the alleles E2 (13.26 %), E3 (93.87 %) and E4 (30.65 %) presence. Based on single nucleotide polymorphism identification, there were defined the following genotypes: E2/E2 (0.65 %), E2/E3 (10.97 %), E2/E4 (1.61 %), E3/E3 (57.74 %), E3/E4 (25.16 %) and E4/E4 (3.87 %). Individuals with E2/E4 genotype had higher levels of total cholesterol (+17.56 %, P < 0.05) and low density lipoproteins (+25.7 %, P < 0.01), and atherogenic index was increased (+38.18 %, P < 0.05) in E4/E4 carriers in comparison with E2/E3. Hypertonic E4/E4 carriers were found to have elevated plasma triglycerides (+20.23 %, P < 0.05) in comparison with E3/E3, as well as increased triglycerides (+25.3 %, p < 0.05) and very low density lipoproteins (+25.33 %, P < 0.05) in comparison with E3/E4 carriers. E3/E3 and E3/E4 carriers demonstrated decrease in total cholesterol (-12.9 %, P < 0.05) and (-11.04 %, P < 0.05), respectively, as well as low density lipoproteins (-15.69 %, P < 0.001) and (-11.48 %, P < 0.05), respectively, as compared to E2/E4. The plasma content of high density lipoproteins was not dependent on ApoE genotype. Conclusions. In patients with essential hypertension, the most common allele is E3 (93.87 %) and the E3/E3 genotype (57.74 %), while the E3/E4 genotype is 25.16 %. Presence of the E2/E4 genotype is significantly associated with the elevated total cholesterol and low density lipoproteins plasma levels, whereas the E4/E4 genotype is accompanied by the increased triglycerides, low density lipoproteins levels and atherogenic index.

In our previous studies it was established that the remodeling of pancreatic islets with decreasing β-cell population density is formed in hypertensive SHR rats. The imbalance between the synthesis of proapoptotic and antiapoptotic factors may be one of the possible causes of disturbed formation of the endocrinocyte population in the pancreas. The aim of the research was to study the parameters of Bcl2 and p53 proteins synthesis in pancreatic islets in normotensive and hypertensive rats in the streptozotocin-induced diabetes mellitus development. Materials and methods. The study was performed on 30 normotensive male Wistar rats (systolic BP=105.0 ±1.1 mm Hg) and 25 hypertensive SHR rats (systolic BP=155.7 ±0.9 mm Hg) with fasting normoglycemia (4.73 ± 0.10 mmol/l). Bcl2 and p53 proteins were detected in histological pancreas sections by immunofluorescence method. The relative area of Bcl2- and p53-immunopositive material, concentration of proteins in endocrinocytes, their content in the islets and apoptosis index p53/Bcl2 were analyzed in pancreatic islands. Results. The area of relative immunofluorescence to the Bcl2 protein was 2 times less, and the protein content was 3 times lower in pancreatic islets of hypertensive rats (SHR) compared with normotensive Wistar rats. At the same time, no statistical differences in the area of the immunopositive material to the p53 protein and its content in the islets between the experimental groups were revealed. The development of streptozotocin-induced diabetes in Wistar rats was accompanied by approximately 2-fold decrease in the Bcl2 protein expression in pancreatic islets, a significant increase in the specific content of p53 protein and a 3.8-fold increase in the apoptosis index of p53/Bcl2. In pancreatic islets of SHR rats, diabetes mellitus development was accompanied by 2-fold increase in the specific content of the proapoptotic protein p53 without the reduction of the antiapoptotic protein Bcl2 synthesis. At the same time, the p53/Bcl2 apoptosis index in SHR rats remained statistically higher than in Wistar rats. Conclusions. Endocrine cells of pancreatic islets of SHR rats are characterized by the prevalence of proapoptotic protein p53 expression as compared with Wistar line normotensive rats. The development of streptozotocin diabetes in Wistar rats leads to a significant decrease in the number of endocrinocytes synthesizing the antiapoptotic protein Bcl2. At the same time, an increase in the synthesis of the proapoptotic protein p53 in endocrinocytes in diabetes is observed both in normotensive and in hypertensive rats.

Background. The rapid development of complications of essential arterial hypertension (AH) in adolescents 16–17 years old, who expose a psychological overload while studying at a higher school, creates prerequisites for predicting the course of hypertension. Materials and methods. The basic group of the study diagnosed with AH consisted of 84 adolescents, 40 (47.6 %) boys and 44 (52.4 %) girls, who according to the office blood pressure (BP) measurements with an interval of one to two weeks at least 2 times had BP values ≥ 120/80 mm Hg, and were found to have blood pressure load > 95 percentile 25–50 % and more of the day time by ambulatory blood pressure monitoring (ABPM). For comparison of the studied parameters, we used data from the control group, which consisted of 40 adolescents (13 (32.5 %) boys and 27 (67.5 %) girls) with normotension. The results of observations were processed using the medical statistics program Statistica version 6.0. Results. The unfavorable predictors of the development of stable AH revealed an average heart rate at night of more than 62 per mi­nute by Holter monitoring, the average daily pulse pressure on the ABPM was more than 57 mm Hg and the body mass index (BMI) is above 25 kg/m2. The risk factors for left ventricular (LV) remo­deling included the excess increase in the thickness of the posterior wall of the LV of more than 8.0 mm at the time of the diagnosis of hypertension, BMI over 25 kg/m2 and average daily pulse pressure over 57 mm Hg by ABPM. Conclusions. If an unfavorable course of hypertension is predicted, then it is necessary to combine non-pharmacological methods of treatment with drug ones.

The aim was to determine the morpho-functional parameters of the left ventricular myocardium NO system in the rats with essential hypertension (SHR line). Material and methods. We used a combination of modern highly informative methods, namely: research of NOS isoform profie (nNOS, iNOS eNOS) in the myocardial slices along with an assessment of their synthesis and expression of the corresponding mRNA; NO derived nitrites level determination directly in the myocardium homogenates and concentration of nitrotyrosine in blood plasma of rats. The results of the performed studies have shown that high blood pressure in the SHR was accompanied by a signifiant increase in the concentrations of all three NOS isoforms in the myocardium and increased expression of their mRNA. Higher concentration of nitrites by 18.8 % was detected in the SHR group compared with the control animals. The concentration of nitrotyrosine in blood plasma of rats with essential hypertension was also increased by 25 %. Conclusions. The predominance of IRM to constitutive isoforms of NOS with low IRM content to iNOS was noted in the myocardium of the control group rats while in SHR rats higher IRM values were marked for all NOS isoforms. The formation of hypertension is accompanied by high content of NO end metabolites and the development of systemic nitroso-oxidative stress with the increase of nitrotyrosine concentration.

Abstract The problem of chronic obstructive pulmonary disease (COPD) in combination with hypertension (HT) is becoming more relevant because of the growth of its prevalence and adverse consequences in the world as well as in Ukraine. Aim: To assess the level of interleukin-18 (IL-18) and IL-10 in patients with COPD in combination with HT. Materials and methods. We examined 87 patients with occupational COPD GOLD 2–3, groups B, C, D. The main group included 67 patients with COPD in combination with HT stage II, the comparison group – 20 patients with COPD. Patients were divided into phenotypes: emphysematous, chronic bronchitic, frequent exacerbator and asthma-COPD overlap syndrome (ACOS) based on the analysis of clinical and anamnestic, anthropometric, spirometric data and chest X-ray examination. The examination was carried out in remission which is characterized by stable clinical symptoms and spirometry indices. General clinical and laboratory examinations, pulse oximetry, pulmonary function test, electrocardiographic, echocardiographic and chest X-ray examinations were performed in all patients. IL-18 and IL-10 in peripheral blood were determined by ELISA using a test system “Bender MedSystems, GmbH” (Austria). The control group included 20 practically healthy age- and gender-matched persons. Statistical analysis of the data was performed using nonparametric statistical methods. The probability of differences in independent groups was estimated using the Mann-Whitney U-criterion. All statistical tests were bilateral, differences were considered significant for P < 0.05. Results. Analysis of IL-18 levels in patients of the main group, comparison group and control group showed statistically significant differences. The most significant increase in IL-18 level was observed in patients of the main group that was associated with more severe systemic inflammation in COPD combined with HT. The level of IL-10 was significantly increased only in the main group. Patients with COPD GOLD 3, groups C, D and COPD GOLD 2, group B did not significantly differ in IL-18 and IL-10 levels, but there was a tendency to decrease in IL-18 and increase in IL-10 levels in patients with COPD GOLD 3, groups C, D due to initial manifestations of IL-18-mediated proinflammatory response exhaustion. Significant differences between levels of IL-18 and IL-10 in patients with COPD with different phenotypes were revealed. IL-18 levels were elevated in all studied patients, but the degree of increase was quite different. Frequent exacerbators demonstrated blunted IL-18-mediated proinflammatory and excessive anti-inflammatory response. Conclusions. Cytokine imbalance in patients with COPD in combination with HT determines the course of disease and may be a prognostically significant criterion for consequences of the disease.

Abstract Objective. To improve the diagnosis of predisposition to Essential arterial hypertension (EH) and Chronic heart failure (CHF) in postmenopausal age’s women by determining the polymorphic genotypes of the first type angiotensin II receptor’s gene (AT1-R) and the corresponding structural and functional state of myocardium. Materials and methods. The study involved 180 women of postmenopausal age, they were residents of Podillya Region of Ukraine. 80 women without signs of cardiovascular diseases were the control group, 100 women with EH included the main study’s group. Genotyping of AT1-R was carried out using the polymerase chain reaction. The distribution of the frequencies of genotypes AT1-R was checked in accordance with the Hardy–Weinberg equilibrium law. The structural and functional parameters of myocardium were evaluated using an echocardiography. The left ventricular’s systolic function was preserved in cases where the left ventricular’s ejection fraction was more than 40 %. Mathematical processing was performed using the standard statistic package Statistica 6.0. Results. In patients with EH genotype AC was detected most often (49 %), AA and AC genotypes weer determined in 40 % and 11 % of patients (РАА-СС≤ 0.05, РАС-СС≤ 0.05) respectively. Carrying allele C of the AT1-P gene was associated with a higher probability of future occurrence of CHF in patients with EH, more significant structural disorders of myocardium and disturbances of systolic and diastolic functions of left ventricle (LV) such as pseudonormal and restrictive types. Conclusions. Allele C associates with the presence of EH and a greater probability of occurrence of CHF in postmenopausal women, residents of Podillya Region, more pronounced disturbances in the structure of myocardium, with diastolic and systolic dysfunctions of LV. Developed mathematical models help to determine approximately the structure of AT1-R according to the parameters of cardiac hemodynamics in the case of impossibility of laboratory investigation.

The main morphological structural lesion substrate is myocardial fibrosis. The processes of fibrosis in a certain way are associated with the severity of a variety of cardiac arrhythmias. Myocardial fibrosis may be manifested by prolongation of the QRS complex, frequent ventricular arrhythmias and ventricular tachycardia on the electrocardiogram. Echocardiography is the main tool used to assess the structure and function of the heart, it reveals an increase in the left ventricle, and decrease in ejection fraction and diastolic dysfunction of the left ventricle and an increase in filling pressure. Biological markers are quantitatively defined biological parameters that, as indicators, determine the norm, pathology and result of medecinal correction of the disease (definition of experts from the Biomarkers Definitions Working Group, USA). Changes of biomarkers can be controlled to determine the individual risk of cardiovascular diseases development and measures to normalize them. Among the main causes of fibrosis activation, hyperactivation of the renin-angiotensin-aldosterone system and, as a consequence, the excessive formation of angiotensinogen and aldosterone are considered; increased levels of galectin-3, which contributes to the migration of macrophages, proliferation of fibroblasts and collagen synthesis in cardiomyocytes. Recently, much attention is paid to the study of biochemical markers such as aldosterone, galectin-3 and transforming growth factorbeta-1.Thus, these markers were determined in hypertension, metabolic syndrome, congestive heart failure, hypertrophic cardiomyopathy, myocardial infarction, atrial fibrillation. However, to date studies considering association between frequent ventricular premature beats, as a marker of electrical instability and plasma levels of biomarkers of fibrosis, such as aldosterone, galectin-3and transforming growth factor beta-1, in patients with essential hypertension without / or in combination with coronary heart disease are absent. Based on the aforesaid material,, further thorough study of this problem is promising. [ABSTRACT FROM AUTHOR]

The aim was to study the dependence of structural changes in the common carotid arteries (intima-media complex thickness and vascular diameter) on the body weight index of hypertensive patients. Material and methods. The study included 84 patients with stage 2 essential hypertension (EH) and 15 healthy people. Groups did not differ significantly in age, gender, height. Patients with EH, depending on the body mass index, were divided into three groups: normal body weight (n = 19), overweight (n = 34) and obesity (n = 31). The study excludes patients with intima-media complex thickness (IMT) of more than 900 μm or atherosclerotic plaques presence in the common carotid arteries (CCA). All patients were measured: "office" ABP, diameter and intima-media complex thickness of the common carotid arteries, structural-geometric and functional indicators of the heart. Results. In patients with EH there is a simultaneous remodeling of blood vessels (a significant increase in IMT of 17,8% and CCA diameter of 6,6%) and the heart (LV hypertrophy, left atrium dilation,LV end diastolic pressure increase). Hypertensive patients with overweight and obesity had significantly higher right CCA diameters by 8.1% (p = 0.016) and 6.9% (p = 0.039), respectively, than those with EH and normal body mass. The left CCA diameter was significantly higher by 8.7% (p = 0.012) in patients with overweight compared to a similar figure in patients with EH and normal body mass. Patients with normal, overweight and obesity with EH significantly did not differ according to the indicators of CCA IMT on both sides. With an increase in the body mass index in patients with EH there is a progressive increase in the left atrium diastolic size: in patients with overweight by 10.7% (p = 0.005) more than in normal body weight patients; and with obesity by 2,5% (p = 0,001) more than in overweight patients. In patients with EH and obesity the right CCA IMT correlated with age (r = 0.41; p = 0.02), EF LV (r = 0.39; p = 0.03), theLV posterior wall thickness (r = 0.37; p = 0.04), E / E '(r = 0.39; p = 0.04). In patients with EH and normal body mass the right CCA IMT correlated with the left atrium diastolic size (r = 0.51; p = 0.02), body weight (r = 0.57; p = 0.01); the left CCA IMT with body weight (r = 0.48; p = 0.04); body mass index (r = 0.61; p = 0.01) and aorta diameter (r = 0.51; p = 0; 02). In patients with EH and obesity the intima-media complex minimum thickness (604 ± 31 μm) occurred in the normal type ofLV geometry and significantly (p = 0.023) increased by almost 100 μm in eccentric hypertrophy and amounted to 703 ± 93 μm. Conclusions. An increase in the body mass index in patients with EH is accompanied by an increase in the common carotid arteries diameter, the left atrium diastolic size, the posterior wall thickness and the left ventricular mass index. In patients with EH and normal body mass the right CCA IMT correlated with body weight (r = 0.57; p = 0.01); the left CCA IMT with body weight (r = 0.48; p = 0.04) and BMI (r = 0.61; p = 0.01). A significant increase in the intima-media complex thickness of the left CCA occurs only among obese patients with eccentric hypertrophy compared with normal left ventricular geometry.

There is necessity to find specific independent risk factors of cerebrovascular complications in hypertensive patients due to lack of sufficient therapeutic approach in its prediction. The aim of the study was to determine dependent and independents risk factors of ischemic stroke among ambulatory blood pressure monitoring, heart rate variability and adenosine-induced (ADF) platelet aggregation data in hypertensive patients. Materials and methods. A total number of 88 patients with essential hypertension (EH) was divided in two groups. In this population, the first subgroup (n=39) was identified as EH individuals with an acute hemispheric ischemic stroke (IS) and the second one − patients (n=49) with well controlled arterial hypertension. In all the patients ambulatory blood pressure monitoring (ABPM), 24-h heart rate variability (HRV) and ADF-induced platelet aggregation (10,0×10-6 mole/l) were conducted. Method of logistic regression analyzes was used. Results. No statistician difference were found between the groups in age (63 ± 9,1 versus 64 ± 11,0 yrs.; р = 0,682, respectively), however, it was in sex parameter (64% male versus 39%; р=0,018, respectively). Onset risk of ischemic hemispheric stroke was associated with ABPM parameters as average systolic BPday (SBP) >132 mmHg; average diastolic BPnight (DBP) >70 mmHg; pulse BP24 >60 mmHg; pulse BPday >58,6 mmHg; pulse BPnight >57,9 mmHg; indexes of hypertension (BP SBP24 load>44, 7% and DBP24 load>37,0%; time index DBPnight >62,6%; square index SBP24 >94,3 mmHg×h and DBP24 >58,4 mmHg×h); AASI24 >0,52; mean BP24 >94,8 mmHg and mean BPnight >87,1 mmHg; pulse BPday variability >11,8 mmHg and pulse BPnight variability >8,2 mmHg; “double multiplication” index > 86,3 mmHg×bmp). Also there is association with HRV parameters as SDNN24 ≤ 91 mc and SDNNday ≤83 mc; SDANN24 ≤99 mc and SDANNday ≤ 76 mc; VLFday ≤63,7%; LFday > 27,1%; index[(HF+LF)/VLF] > 0,56. And with max level of platelet aggregation parameter with ADF as aggregation inductor as >65,2%. In model independent risk factors of IS was SDNNday (OR = 56,6; р = 0,011); SBP24 load (OR = 40,9; р = 0,033); average SBPday (OR = 30,0; р = 0,021) and PBPnight variability (OR = 15,1; р = 0,043). Conclusions. The independent risk factors of ischemic hemisphere stroke in hypertensive individuals are daily SDNN, blood pressure load of diurnal systolic blood pressure and night variability of pulse blood pressure. The maximum level of ADF-induced platelet aggregation more than 65,2% is a dependent risk factor, which augmented odd rate of ischemic stroke in 6,5 times (р = 0,007).

Risk of cardiovascular and cerebrovascular events development in psoriasis patients is higher than in population as a whole. Combination of arterial hypertension and psoriasis is widespread and understudied state, thus the objective of our work was to reveal features of this comorbid pathology formation and course. Material and Methods. For the implementation of the set task specific features of clinical picture of arterial hypertension (presented by essential hypertension) and psoriasis were studied. Two groups of patients included 47 persons suffering from essential hypertension and 98 persons suffering from psoriasis and essential hypertension simultaneously. Dermatosis course severity was estimated clinically using PASI index, 24-hour blood pressure index was determined by means of 24-hour blood pressure monitoring. Levels of cytokines, cortisol, and insulin were determined by immunoenzymatic methods. Results. As the result it was revealed that patients with comorbid pathology have severe and moderate degree of arterial hypertension more often than in case of arterial hypertension without dermatosis (95 % vs. 85 %). In this group of patients the specific feature of blood pressure circadian rhythm was revealed in form of its insufficient decrease in the evening and at night (non-dipper and night-peaker groups); total number of such patients made 63.64 %. Levels of cytokines (IL-β,IL-1α, IL-6, TNF-α) in the group with comorbid pathology greatly exceed the similar indices of patients without dermatosis. This fact can be explained by available severe form of psoriasis (exudative, arthropica) with expressed systemic inflammatory reactions. Interleukins levels critically increased in patients with the 3 degree of arterial hypertension in case of combined pathology. It has been found that duration of disease especially in case of psoriasis and arterial hypertension severe form combination had negative influence on adaptive mechanisms. This fact was confirmed by considerable decreasing in cortisol level (difference made 39.74 % in favor of patients with the 1–2 degree of arterial hypertension) and increasing of insulin in blood (difference made 31.91 % in favor of patients with the 1–2 degree of hypertension in case of comorbid pathology). Conclusions. Thus, psoriasis and arterial hypertension combination creates conditions for the systemic inflammatory process formation with prominent clinical manifestations of both dermatosis and hypertension, specific features of blood pressure circadian rhythm, chronic stress and decompensation formation in case of long course of disease and hypertension severe form development. arterial hypertension; essential hypertension; psoriasis

ATP-sensitive potassium channels (KATP-channels) have an exclusive cardioprotective role in endogenous heart protection from ischemic damage and regulate vascular tone. KCNJ11 (Kir6.2) polymorphisms I337V (rs5215) and G23L (rs5219, E23K), and ABCC8 (SUR1) polymorphisms S1369A (rs757110) was genotyped in 529 patients with myocardial infarction, acute and chronic heart failure, in adolescents with primary hypertension, and as control group in clinically healthy subjects of Ukraine population by the real-time polymerase chain reaction (RT-PCR). It was shown that the frequency of genotypes Glu/Glu, Glu/Lys and Lys/Lys of polymorphism E23K, and genotypes Ser/Ser, Ser/Ala and Ala/Ala of polymorphism S1369A was as follows: in 107 patients with myocardial infarction - 40.2, 43.9 and 15.9%; in 96 patients with acute heart failure - 41.7, 42.7 and 15.6%; in 99 patients with chronic heart failure - 43.4, 44.4 and 12.1%; in 104 adolescents with primary hypertension - 41.4, 46.2 and 12.5% respectively. The distribution of these genotypes in the control group in 98 clinically healthy people was 37.8, 46.9 and 15.3% respectively. Inheritance of SNPs E23K and S1369A were linked. The frequency of genotypes Ile/Ile, Ile/Val and Val/Val of polymorphism I337V was as follows: in 102 patients with myocardial infarction - 32.4, 51.0 and 16.7%; in 93 patients with acute heart failure - 37,6, 43,0 and 19,4%; in 98 patients with chronic heart failure - 40,8, 44,9 and 14,3%; in 90 clinically healthy people - 35.6, 45.6 and 18.9% respectively. Incidence of allelic polymorphisms I337V, E23K and S1369A corresponds to Hardy-Weinberg principle. By criterion χ², no significant differences were found between the groups. Thus, the frequency of allele polymorphisms I337V, E23K, and S1369A in patients with myocardial infarction, acute and chronic heart failure, and primary hypertension in adolescents was determined, and it has been shown that it does not significantly differ from the frequency in clinically healthy residents of Ukraine. [ABSTRACT FROM AUTHOR]

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Objective: to study the features of metabolism of nitric oxide and thiol-disulfide balance parameters in patients with psoriasis combined with essential hypertension. Materials and metods. The study of thiol-disulfide balance and nitrogen metabolism were performed in 95 patients who were divided into 3 groups: Group I - psoriasis and hypertension - 25 people; II group - patients with psoriasis only - 30 and Group III - patients with hypertension only - 40 people. To assess psoriasis severity index we used Psoriasis Area and Severity Index (PASI). The level of reduced and oxidized glutathione in plasma was evaluated with fluorometric method with further calculating their ratio. Results. In patients with hypertension status thiol-disulfide systems change were fairly minimal compared to a group of patients with psoriasis only and comorbid disorders. During examination the patients with combined pathology of psoriasis and essential hypertension in the progressive phase of the disease revealed significant changes in glutathione systems and free-radical oxidation, characterized by a significantly decrease in the content of reduced glutathione (16,5±0,48 mmol/l) and increased content of oxidized glutathione (3,23±0,06 mol/l), while reducing the activity of the enzyme superoxide dismutase (24,21±1,44 conventional units /mg protein/min) and reduction ratio of the recovered / oxidized glutathione to 5,1±0,26 conventional units. In patients with psoriasis with increasing severity of thiol-disulfide balance violations we recorded a significant deterioration in the clinical situation and reduced quality of life. These changes characterize the progression of endothelial dysfunction in these patients. Conclusion. Formation of psoriasis progression was significantly associated with low functional capacity glutathione link of antioxidant system and with the inability to adequately replenish the pool of reduced glutathione. Since oxidative stress arises not only when the redundancy of reactive oxygen forms, but also in the failure of the antioxidant system, the state of protective enzymes in the pathologically altered skin epidermis in the dynamics of the process and the pathogenesis of essential hypertension may be potential therapeutic targets.

Blood pressure (BP) has been identified as a risk factor for various health disorders, including stroke onsets. Hypertension is one of the crucial health problem among adult Ukrainian. Due to the importance of elevated BP in stroke causality, BP measurement remains critical. However, it is limited information about value in clinical practice of ambulatory blood pressure monitoring (ABPM) data in hypertensive patients with inadequately controlled BP with acute stroke compared with those individuals who has no vascular onset. The aim of the study was to determine ABPM parameters in essential hypertensive patients with ischaemic hemisphere stroke. Materials and methods. A total of 114 study participants were analyzed (mean age 62 (56;72) years, 40 % women). We divided them into two groups according to the level of 24-h systolic BP (SBP) and diastolic BP (DBP), and the results of clinical examination. The first group (n=83) were inadequately controlled essential hypertensive individuals with high systolic or/and diastolic BP level according to the ABMP results, and the second one (n=31) were EH patients with an acute hemispheric ischaemic stroke (IS). Diagnosis of stroke was confirmed with clinical examination and computed tomography scan or magnetic resonance imaging results, and ABPM was conducted in 4.2±2.3 days after the stroke onset. Results. We had statistician difference (p

Ambulatory blood pressure monitoring (ABPM) is a modern method of blood pressure (BP) investigation recommended by international scientific associations for diagnostics of essential hypertension (EH). However, there are some methodological aspects which are not regulated. Particularly, ABPM parameters have not yet established for those patients in different age groups and pathologies. The aim of the study was to determine peculiarities of ABPM parameters in treated controlled hypertensive and normotensive patients. Materials and methods. 71 patients were included into the study and divided into two groups according to the level of 24-h systolic BP (SBP) and 24-h diastolic BP (DBP). There were 50 controlled patients with EH in the first group and 21 normotensive individuals without EH in the second group. Results. In EH patients and normotensive individuals we had statistician difference of such parameters, like the hypertension time index (TI) of day SBP parameters (20 (8–31) % vs. 8 (4–18) %; р=0.040); of the square index (SI) of hypertension (24 (11–41) mm2/h vs. 8 (2–23) mm2/h; р=0.021); of the square index normalized (SIN) of hypertension (1.4 (0.6–2.4) U vs. 0.4 (0.1–1.2) U; р=0.018,) and the morning surge of SBP (45±14 mm Hg vs. 37±14 mm Hg; р=0.028, respectively). There is no different in other ABPM parameters. Conclusion. The present data shows that treated controlled hypertensive patients and individuals without EH have statistician difference only in daily SBP of hypertensive indexes (TI, SI, SIN) and the morning surge of SBP. The other ABPM parameters, included new one, such as the arterial stiffness index, did not represent statistical difference between groups.

In 41 patients with essential hy­pertension I and II degrees telmisartan influence on parameters of intimate heodynamics and functional condition of myocardium of LV has been studied. Carried out researches have shown, that on a background of treatment with telmisartan reduction of final diastolic volume of LV, final systolic meredional stress and final diastolic pressure of the myocardium and increase in fraction of LV ejection emission and speed of circular reduction of myocardium fibres is marked. The specified changes may be explained by improvement of plastic characteristics of the myocardium that is caused both by direct action of telmisartan on the myocardium through blockade of a local renin-angiotensin- aldosterone system, and by the mediated influence due to decrease of blood pressure and after post loading.

The problem of blood pressure (BP) effective control in Ukrainians is still relevant. Ambulatory blood pressure monitoring (ABPM) is a modern method of BP investigation. However, only some ABPM parameters, as diurnal systolic BP (SBP) and diastolic BP (DBP), now use as the diagnostic guide according to international recommendations. Aim. To determine peculiarities of ABPM parameters in treated uncontrolled hypertensive patients. Materials and methods. We investigated 153 patients with essential hypertension and divided two groups according to the level of 24-h SBP and 24-h DBP. There were 103 patients who have uncontrolled levels of BP in the first group and 50 patients with normotensive individuals in the second group. Results. We had a significant increase of SBP (21,8%; р=0,001), DBP (21,5%; р=0,001), pulse BP (PBP) (22,8%; р=0,001) and the morning surge in SBP (20,7%; р=0,004) in the first group versus the second group. Furthermore, there was a considerable rise in such parameters, like the square of hypertension of diurnal SBP in 9,2 times (р=0,001), daily in 9,5 times (р=0,001), nocturnal in 8,6 times (р=0,001); index of the square of diurnal DBP reduction in 7,2 times (р=0,001), daily in 8,1 times (р=0,001) and nocturnal in 5,7 times (р=0,001) in the first group than in the second group. There was no significant difference in index of night reduce of SBP, speed of morning rise of SBP and DBP, ambulatory arterial stiffness index (AASI) and symmetric slope index (sym_AASI). Conclusion. This study shows that treated non-controlled hypertensive patients have 20-25% increase in diurnal SBP, DBP and PBP. There is a night-fold increase in diurnal index of SBP square hypertension and a DPB seven-fold increase in diurnal index of square hypertension. There is no statistical significance in index of night reduce of SBP, speed of morning rise of SBP and DBP, AASI and sym_AASI.

Background. Issues of lesion pathomorphogenesis in epithelial component of the skin in patients with psoriasis and hypertension on the background of the skin involutive changes requires clarification and further development. The aim of research is to determine the structural damage to epidermis in psoriasis patients depending on the presence or absence of hypertension. Materials and methods. In 60 patients skin biopsies were studied using light-optical microscopy. Quantitative morphological study was conducted using software package ImageJ 1,47v and common principles of morphometric analysis. Results. Morphological examination of the skin condition in elderly patients of the control group revealed typical involutive changes in the epidermis. In particular, the epidermis on the surface of smoothed papillae was unevenly thinned. The maximum total thickness of basal, spinous and granular layers was 41,7 ± 5,1 µm, the minimum – 26,3 ± 3,6 µm. In the loci of thinning (above the tips of papillae) cell ratio in layers of epidermis remained without pathological features. Conclusion. It was found that the morphological substrate of epidermal damage in patients with psoriasis and hypertension is a complex of local violations of the epithelial structure of the skin component: perifocal hyperplasia and degeneration of keratinocytes with acantholysis and destruction of the dermal-epidermal connection, including fragmentation of the basement membrane of the epidermis. This triggers the cascade of typical pathomorphological changes which intensity is significantly higher than the skin lesions in psoriasis patients without hypertension. In the active phase of psoriasis presence of hypertension aggravates the degree of local damage of the epidermis, strengthening the development of hyperkeratosis, parakeratosis, papillomatous hyperplasia, extracellular and cytoplasmic edema of epidermocytes, separation and detachment of the epidermis due to extravasations, Munro’s microabscesses, leukocyte infiltration, erythrodiapedesis, and hemorrhage. Psoriasis; Essential Hypertension; Skin; Epidermis; Morphology

The aim. To study Vascular Endothelial Growth Factor-A expression in patients with both psoriasis and hypertension. Methods and results. 102 patients were included. Vascular Endothelial Growth Factor-A level was detected with indirect ELISA method. It was found that VEGF-A level was maximal in patients with psoriasis and hypertension stage II - 694.44 (567.36–829.87) pg/ml. That was statistically significantly higher (p

The combination of psoriasis and hypertension influences on the clinical course of both diseases. Aim. In order to study gender peculiarities of psoriasis and hypertension, we examined 81 patients suffering from both psoriasis and hypertension. Methods and results. It was found that there are significant differences in factors, clinical manifestations of psoriasis, peculiarities of the clinical course of both dermatosis and hypertension, their relationship. Conclusions. Most men with psoriasis in combination with hypertension were aged 55 –65 years, and women - 45 to 55 years. There were also some differences in concerning body weight. In common the most part of the patients was with normal or increased weight or with 1st stage of obesity. At the same time, male patients with III degree of obesity were by 8.33% more than women. Stress was identified among factors that provoke onset or exacerbation of dermatosis in 77.78% of women and 51.11% of men; indeterminate triggers were on the second place and season of the exacerbation occurring – on the third. Although heredity and season were on the second and third place in women. Severe dermatosis with PASI values above 30 points were diagnosed in 64.2% of patients; men more often had exudative and arthropathic form of psoriasis and women - only аrthropathic form of dermatosis. Patients with above-mentioned severe forms had also violations of the circadian rhythm of blood pressure in the form of low decline in the evening and night hours.

In 41 patients with essential hy­pertension I and II degrees telmisartan influence on parameters of intimate heodynamics and functional condition of myocardium ofLVhas been studied. Carried out researches have shown, that on a background of treatment with telmisartan reduction of final diastolic volume of LV, final systolic meredional stress and final diastolic pressure of the myocardium and increase in fraction of LV ejection emission and speed of circular reduction of myocardium fibres is marked. The specified changes may be explained by improvement of plastic characteristics of the myocardium that is caused both by direct action of telmisartan on the myocardium through blockade of a local renin-angiotensin- aldosterone system, and by the mediated influence due to decrease of blood pressure and after post loading.

The study involved 63 patients with essential hypertension and diabetes mellitus type 2. The control group consisted of 16 apparently healthy individuals. Complex of examination included conventional clinical-laboratory and instrumental methods, ultrasound of the heart with Doppler sonography, determining apelin blood concentration by ELISA. Patients with essential hypertension and diabetes mellitus type 2 compared with the control group had a probable reduction in apelin level associated with the development of pathological cardiac remodeling, increasing the size of the left atrium and diastolic dysfunction of the heart.

The urgency of the problem is determined by the frequency of comorbidity of psoriasis by essential hypertension. Aim. In order to study the level of TNF-α in patients with psoriasis in combination with essential hypertension 102 patients were examined. Methods and results. The main group (I group) consisted of 27 patients with psoriasis in combination with essential hypertension. There were two groups of comparisons: 26 patients with psoriasis (II group) and 49 patients with essential hypertension (III group). Severity of the disease was assessed with Psoriasis Area and Severity Index (PASI). Patients completed questionnaire The Dermatology Life Quality Index (DLQI) to study the quality of life. Determination of TNF-α in the serum were provided by indirect ELISA. It was found that patients from the 1st group more frequently had widespread forms of dermatosis, with frequent relapses, psoriatic arthropathy. Conclusion. Cytokine activation correlated with worsening of the life quality. Regressive analysis revealed association between psoriasis severity and TNF-α serum level in patients from the main group.

The paper identifies the main reasons for the development of an aneurysm of the ascending aorta and predictors of its complications in patients of all ages. To determine the cause and age-associated risk factors for aneurysms there were examined 154 patients with the presence of the expansion of the root and / or ascending aorta of more than 40 mm, according to echocardiographic examination. Patients were divided into 4 categories by age: 18-29 years, 30-44 years 45-59 years 60-74 years. Instrumental methods of examination: echocardiography, ECG, ECG monitoring and blood pressure, heart rate variability, ultrasound of internal organs were used. Syndrome of connective tissue dysplasia was established according to the criteria of the working group of the British Society of Rheumatology. Joint hypermobility syndrome was determined according to the Brayton criteria. Statistical processing was carried out by methods of variation statistic program StatSoft "Statistica" v.10.0. It was established that in young and middle aged patients the cause of aneurysm of ascending aorta more often is connective tissue dysplasia syndrome. In older patients the main cause of aneurysm of ascending aorta is associated with left ventricular hypertrophy and decreased contractile function of the heart.

The aim of the study was to determine the peculiarities of changes in daily blood pressure (BP) and its variability in patients with essential hypertension (EH) and diabetes mellitus type 2 (DM type 2). 150 patients of average age 53.4 ± 5.3 years old were examined. Patients were divided into groups: 30 healthy persons, 30 patients with DM type 2, 30 patients with EH and 60 patients with EH combined with DM type 2. Daily BP monitoring (DBPM) was performed using the apparatus ABPM-04. The patients with DM type 2 compared to healthy persons were found to have significantly increased (p < 0.05) daily, daytime and night diastolic BP (DBPdaily, DBPnight, DBPday). Time indexes of night systolic blood pressure (SBPnight) and daytime systolic blood pressure (SBPday) were elevated by 2.01 and 1.80 times. There was significantly increased rate pressure product (RPP) that was a marker of a high level of load with high blood pressure in those patients. In patients with essential hypertension combined with diabetes mellitus type 2 associated with II stage hypertension in comparison with a group with essential hypertension, the parameters of DBPM did not much differ, and the indices of SBPdaily, SBPday, SBPnight, were significantly (p < 0.02) reduced, and the rate of DP was significantly (p < 0.05) higher versus the group of comparison. In patients with III stage hypertension the parameters of night blood pressure decrease (SBP, DBP) were significantly higher. There were significantly (p < 0.05) elevated the DP values, daily and night blood pressure, that was a marker of unfavorable hemodynamic parameters during the day and especially at night. In patients with essential hypertension combined with diabetes type 2 dipper and non-dipper circadian rhythms prevailed. They had higher values of SBP variability in the daytime, load with high blood pressure in the daytime and at night; the degree of the insufficient night reduction and morning increase of BP. Those parameters were significantly in non-dipper circadian rhythm.

The main purpose of the study was to investigate the changes of systemic hemodynamics in patients with essential hypertension stage II in combination with type 2 diabetes, depending on the type of left ventricular remodeling. The research involved 150 patients aged 38 to 65 years old (average age was 53.7 ± 5.6 years). The main group consisted of 60 patients with essential hypertension stage II in combination with type 2 diabetes. The comparison groups consisted of 30 apparently healthy individuals, 30 patients with essential hypertension and 30 patients with type 2 diabetes of the same age. The ultrasound studies have shown that patients of the main group have more adverse types of myocardial remodeling with a predominance of eccentric hypertrophy and concentric remodeling. Accordingly, in the same group of patients, there are more severe violations of systemic hemodynamics with a significant decrease in stroke volume, systolic index against the background of high total peripheral vascular resistance and prevalence of eukinetic and hypokinetic types of systemic hemodynamics. The correlations with the main indicators of the intracardiac systemic hemodynamics confirm a single pathogenetic mechanism of the cardiovascular remodeling in patients with hypertension combined with type 2 diabetes.

The article provides the results of studying the effectiveness of α-lipoic acid impact as a part of complex therapy on endothelial dysfunction in patients with essential hypertension and type 2 diabetes mellitus. There were revealed a significant improvement in metabolic homeostasis, decreased severity of endothelial dysfunction, reduced levels of inflammatory cytokines under additional use of α-lipoic acid compared with standard therapy.

Introduction. Obstructive sleep apnea (OSA) – a condition accompanied repeated, stop of breathing due to complete (apnea) or partial (hypopnea) narrowing of the airways during sleep at throat and termination of pulmonary ventilation with preserved respiratory effort which appears snoring, reduced partial pressure Blood oxygen, fragmentation of sleep with frequent short-term awakening and daytime sleepiness. Awakening becomes a protective mechanism that activates muscles-dilators of the upper respiratory tract and prevents asphyxiation. Aim. To review the literature on sleep disorders in medical practice of internists, to identify the risk factors of OSA in patients with essential hypertension (EH) and obesity (OB). Materials and methods. A review of literary sources on clinical signs and diagnoses of OSA syndrome was made. We examined 41 patients with EH of the 2nd stage, 1-3rd degree and 1st degree of gynecology. The CG included 27 people (15 men and 12 women) aged 50.2±2.2 years with a body mass index (BMI) 34.0±1.0 kg/m2, with complaints of snoring and sleep disorders. The CG included 14 people (7 men and 7 women) at the age of 47.1 ± 2.9 years, with BMI 31.5±1.1 kg/m2. All the patients were routinely screened according to the Ministry of Health of Ukraine N 384 dated May 24, 2012, and were interviewed by the American Apnea Sleep Association questionnaire. Results. The main symptoms that help to suspect OSA are neurocognitive: pronounced daytime sleepiness, annoyance, weakening of memory and attention, suppression of emotions, apathy, intellectual degradation. The increase of the severity of the syndrome leads to disorders of the cardiovascular system, in particular, increased blood pressure, occurrence of atrial and ventricular arrhythmias. In the main group of surveyed patients, the average score of the questionnaire was 12.6 points. All men and 91.7% of women showed a high probability of sleep apnea (> 10 points). In CG the average score was 7.4 points (p

The aim of our study was to prove the effectiveness of drug therapy with beta-adrenoblocker nebivolol (Nebilet®, BERLINCHEMIE AG, Germany) in combination with the angiotensin converting enzymeinhibitorenalapril (ENAP®, KRKA, Slovenia) in the treatment of miners with arterial hypertension and concomitant ischemic heart disease. A total of 88 miners underwent general clinical examination, ECG at rest, ambulatory monitoring of blood pressure and ECG. The observation period was 3 months. It was shown, that the treatment of the mining industry workers with arterial hypertension and coronary artery disease with the combination of beta-blocking agent Nebilet and the angiotensin converting enzyme inhibitor ENAP is well tolerated by patients. This therapy improves the daily profile of blood pressure and positively affects the variability of the heart rate, which will reduce the risk of sudden cardiac death in this category of patients. [ABSTRACT FROM AUTHOR]

In 32 patients with essential hypertonia o f which 17 with I degree and 15 with II degree o f hypertonia the influence o f bisoprolol on parameters of daily monitoring o f arterial pressure has been studied. Bisoprolol was administered once in day in a dose o f 5 mg. Course o f treatment made up 18-21 days. Carried out researches have shown, that bisoprolol therapy led to a stable decrease in arterial pressure, this effect was growing during the course o f treatment. Therewith a multifaceted corrective influence on parameters o f a daily profile o f arterial pressure was marked, owing to this the rate o f daily rise o f arterial pressure decreased. [ABSTRACT FROM AUTHOR]

Aim of study: To study the levels of proinflammatory activation markers and establish their importance in the pathogenesis of cardiovascular remodeling in patients with essential hypertension stage II. Materials and methods. 107 patients with essential hypertension stage II aged 31-73 years (mean age - 53,89 ± 0,88) were included in the study. Depending on the presence of lesions brachiocephalic arteries patients with hypertension were divided into two groups: the first group consisted of patients with essential hypertension stage II without brachiocephalic arteries pathology, and the second - hypertension stage II with stenotic lesions of brachiocephalic arteries. The control group consisted of 31 healthy individuals. Ambulatory blood pressure monitoring, determination the thickness of intima-medial complex of the common carotid artery, echocardiography and pulsed - wave Dopplerography, determination of C-reactive protein, α-tumor necrosis factor and sICAM-1 in the serum were conducted for all patients who were included in the study. Results and discussion. Daily average, nightly average, and maximum values of systolic and diastolic blood pressure were significantly higher in patients with first and second clinical group compared with those in the control group. In the second group daily level of average systolic blood pressure was higher on 9,8% (p

Plasma level of C-natriuretic peptide (CNP) and endothelin-1 (ET-1) was performed among postmenopausal age’s women, patients with essential hypertension (EH), which complicated myocardial infarction or cerebral stroke, who live in Vinnitsa region, with inherent of different variants of angiotensin II type 1 receptor gene. Genotyping gene AT1R was carried out using polymerase chain reaction (PCR) after selecting of genomic DNA from leucocytes of the venous blood. For determination the concentration of CNP and ET-1in plasma of the patients the ELISA method was used. It is shown that plasma level CNP and ET-1is reliable higher in patients of all groups with AC and CC genotypes, compared with AA genotype (р

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In 41 patients with essential hypertension I and II degrees telmisartan influence on parameters of intimate heodynamics and functional condition of myocardium of LV has been studied. Carried out researches have shown, that on a background of treatment with telmisartan reduction offinal diastolic volume of LV, final systolic meredional stress and final diastolic pressure of the myocardium and increase in fraction of LV ejection emission and speed of circular reduction of myocardium fibres is marked. The specified changes may be explained by improvement of plastic characteristics of the myocardium that is caused both by direct action of telmisartan on the myocardium through blockade of a local renin-angiotensin- aldosterone system, and by the mediated influence due to decrease of blood pressure and after post loading. [ABSTRACT FROM AUTHOR]

Introduction. Uncontrolled hypertension is observed in 65-92% of hypertensive patients. It plays an important role in the development of adverse cardiovascular events and survival, which depend on subclinical target organ damage. There are reports on the relationship between ineffective hypertension control and left ventricular (LV) hypertrophy or large arteries stiffness. However, the nature of the remodeling in uncontrolled hypertension remains poorly understood. Objective: to study the character and relationship of left ventricular and arterial remodeling depending on effectiveness of hypertension control. Design and method. We performed a study of 363 hypertensive patients (160 men and 203 women aged 50,8 ± 1,2 years) without comorbidities, which were divided into 3 groups according to the effectiveness of blood pressure (BP) control: 160 patients with controlled hypertension, 142 patients with uncontrolled hypertension and 61 patients with resistant hypertension. Uncontrolled BP based on measured systolic BP≥140 mmHg and diastolic BP≥90 mmHg. Remodeling indexes of left ventricular, elastic (common carotid) and muscular (brachial) artery were evaluated by the ultrasonic method. The severity and character of diastolic dysfunction, hypertrophy, types of remodeling and stiffness were assessed. Statistical processing of the results was performed using Student's t criterion and Pearson correlation analysis. Results and discussion. According to the results of the study, uncontrolled hypertension affected the development of subclinical cardiovascular lesions negatively. Thus, LV hypertrophy was detected more frequently in the third group (91,8% in resistant hypertension versus 46,8% in controlled hypertension, p