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Metabolic syndrome (MS) is a complex pathogenic condition, many mechanisms of which involve uric acid. Inflammation, endothelial dysfunction, atherogenesis and insulin resistance are largely determined by high level of uric acid. Focus on the identification of hyperuricemia is the prerequisite for successful management of cardiovascular risk. The choice of antihypertensive and lipid-lowering drugs in MS should be determined by their ability to control the level of serum uric acid.

According to recent guidelines of AASLD, AGA and ACG, NAFLD is a liver disease accompanied by the accumulation of fatty acid content greater than 5% of hepatocytes weight, absence of substantial alcohol consumption (20 g per day for men, 10 g per day for women), absence of hepatitis viruses and other specific causes of liver disease.

Metabolic syndrome (MS) is a combination of hormonal, metabolic and clinical disorders, and one of the most studied subjects in the modern medicine. Today MS is considered to be a major risk factor for cardiovascular disease, disorders of carbohydrate metabolism and pathology of the reproductive system [6, 41].

Algorithm for selection of antihypertensive treatment in patients with metabolic syndrome and hypertension ACE inhibitors and angiotensin II receptor blockers are major antihypertensive classes of drugs used in the treatment of hypertension in patients with metabolic syndrome. Each drug in the group is characterized by specific clinical and pharmacological features and application patterns. An algorithm for differential choice of drugs is suggested based on the review of their peculiarities.

Objective: to evaluate the antihypertensive efficacy and effect of nebivolol and valsartan on metabolic parameters and erective function in patients with hypertension, metabolic syndrome, and erectile dysfunction. Subjects and methods. A 12-week randomized, blind, controlled, parallel-group, comparative (nebivolol versus valsartan) trial enrolled 40 patients with hypertension, metabolic syndrome, and erectile dysfunction. Results. There were no significant differences between the drugs in their antihypertensive efficiency. Nebivolol exerted a more pronounced positive effect on cardioand angioprotection and lipid and carbohydrate metabolic parameters. It had no negative effect on metabolic parameters. Therapy with nebivolol versus valsartan produced a pronounced positive effect on blood androgen levels and erectile function. Moreover, the quality-of-life indicators also showed a significant improvement in the nebivolol group. Evaluation of the tolerability and adverse reactions of the drugs demonstrated no side effects in both groups.

Aim: to evaluate the antihypertensive efficacy and effects of telmisartan and losartan on metabolic parameters in patients with arterial hypertension and metabolic syndrome. Subjects and methods. A blind randomized, controlled, parallel group comparative (telmisartan versus losartan for 24 weeks) trial enrolled 60 patients with arterial hypertension and metabolic syndrome. Results. Significant differences were found in favor of telmisartan in antihypertensive activity, cardio-, angio-, and nephroprotection and ability to improve lipid and carbohydrate metabolic parameters. Only did telmisartan reduce the manifestations of insulin resistance and hyperleptinemia in patients with hypertension and obesity. Therapy with telmisartan versus losartan exerted a pronounced positive effect on anthropometric parameters and fat deposition rate. The drugs were found to be well tolerated and to cause no adverse reactions in both groups.