Background. The aim was to establish the features of hemodynamic and metabolic parameters in obese patients with true and pseudo-resistant arterial hypertension (AH). Material and methods. The study included 200 patients with uncontrolled AH and obesity. Patients were initially prescribed dual antihypertensive therapy. Those patients who did not reach target blood pressure (BP) levels after 3 months on dual therapy were additionally prescribed a third antihypertensive drug. Of the 98 patients who were assigned to triple therapy, 48 patients did not reach target BP (27 patients had pseudo-resistant and 21 patients had true resistant AH). These patients were additionally prescribed a fourth antihypertensive drug (spironolactone). The effectiveness of the treatment was evaluated 6 months after the start of antihypertensive therapy. Results. After 6 months of therapy, unlike patients without resistance, individuals with resistant AH had more pronounced cardiovascular remodeling and metabolic disorders, disbalance of oxidative stress-antioxidant protection, proinflammatory activity and higher activity of the renin-angiotensin-aldosterone system. Patients with true resistance differed from pseudo-resistant patients by having significantly lower body mass index (BMI); in the absence of differences in BP levels, cardiovascular remodeling, lipid and carbohydrate profiles, patients with true resistance had significantly higher levels of aldosterone, higher activity of oxidative stress system, lower levels of general antioxidant protection, higher adiponectin levels, and lower leptin level. Conclusions. Obese patients with true resistance differed from pseudo-resistant patients by having significantly lower BMI, higher aldosterone levels, more pronounced imbalance of the system of oxidative stress-antioxidant protection and less pronounced adipokine imbalance.

Patients with NAFLD (non-alcoholic fatty liver disease) and subclinical hypothyroidism are at risk of cardiovascular complications that cause cardiometabolic changes, thus enabling to broaden our understanding of the cardiovascular events risk in a comorbid patient. The aim: The study of hormonal and metabolic indicators and cardiovascular risk factors in women from NAFLD combined with SH (subclinical hypothyroidism) depending on the age. Materials and methods: 128 patients with NAFLD were studied, which were divided into 2 groups: І group – patients with NAFLD and level of thyroid-stimulating hormone (TSH) – 4 to 10 mIU/mL (n=45), ІІ group - patients with NAFLD and level of TSH >10 mIU/mL (n=49). The control group consisted of 34 NAFLD patients without SH. Depending on the level of TSH and age, degree of cardiovascular risk, indicators of carbohydrate and lipid metabolism, as well as the indicators that reflect ED were evaluated. Results: Comparison of metabolic parameters in two groups showed a significant difference (p<0.01 between indicators depending on the TSH level, where patients were below 50 years of age: HbA1c, LDL cholesterol, HDL cholesterol, gamma-glutamyltranspeptidase (GGTP). The levels of CDEC (circulating desquamated endothelial cells), VEGF (vascular endothelial growth factor), CRP (C-reactive protein) and TNF-α (tumor necrosis factor-α) were dependent not only on TSH, but also on age. Significant differences (p=0.001) were obtained in patients aged ≤ 50 years: CDEC; VEGF, CRP; TNF-α. Conclusions: Patients from NAFLD combined with SH have hormonal-metabolic disorders, and their degree depends on the TSH level. Early cardiometabolic changes in women are formed already at the age under 50 years, which indicates the formation of early atherosclerotic vascular changes

Background: Hereditary component plays a significant role in the formation of insulin resistance (IR) - one of the pathogenetic links of arterial hypertension (AH) and type 2 diabetes mellitus (DM2). However, the genetic predisposition to IR can not be realized and does not manifest itself clinically in the absence of appropriate factors of the environment (excessive nutrition, low physical activity, etc.). Objective: The review summarizes the results of studies which describe the contribution of genetic polymorphism to the formation and progression of AH, DM2 and their comorbidity in various populations. Results: In many studies, it has been established that genetic polymorphism of candidate genes is influenced by the formation, course and complication of AH and DM2. According to research data, the modulating effect of polymorphism of some genetic markers of AH and DM2 on metabolism and hemodynamics has been established. The results of numerous studies have shown a higher frequency of occurrence of AH and DM2, as well as their more severe course with adverse genetic polymorphisms. At the same time, the role of genetic polymorphism in the formation of AH and DM2 differs in different populations. Conclusion: Contradictory data on the influence of gene polymorphisms on the formation of AH and DM2 in different populations, as well as a small number of studies on the combined effects of several polymorphisms on the formation of comorbidity, determine the continuation of research in this direction.

Studies in 47 right-handed subjects with right and left leading eyes addressed the latent periods of visually-evoked saccades in the horizontal, vertical, and diagonal directions within the field of vision. Visual environments with three levels of temporospatial complexity and two standard time protocols of visual stimulation, with "gap" and "overlap," were used. In subjects with left leading eyes, saccades were more often performed with shorter latent periods in the direction ipsilateral to the leading eye than in the contralateral direction (53% versus 20%); among subjects with right leading eyes, the proportions with decreases in the latent periods in the ipsi- and contralateral directions were different (25% and 22%, respectively). Thus, there was a relationship between eye dominance and the spatial asymmetry of the latent periods of saccades.

This is the published version of the paper.This version of the publication may differ from the final published version. Permanent repository link AbstractIn this article the problems of the prevalence of esophageal cancer and the spatial distribution of mortality rates from this disease are considered using as examples the NUTS 2 regions in six countries of Central and Eastern Europe (Austria, Germany, the Czech Republic, Poland, Slovakia and Hungary). The rates of mortality from esophageal cancer are analyzed by statistical methods and by spatial econometrics. A study is carried out of the features of the spatial distribution of the rates of mortality from esophageal cancer. It allows us to determine more and less epidemiologically affected regions and to carry out more detailed studies on the link between the mortality rates from esophageal cancer and various factors, such as the environmental situation, socio-demographic characteristics of the population, culture and nature of nutrition, the general health status of the population, the availability of resources and the level of healthcare in the region. By means of the multifactor regression model we forecast the rates of mortality from esophageal cancer, taking into account characteristics of the countries, the dynamics of the number of patients with diseases of the esophagus and the general time trend.

Heterozygous familial hypercholesterolemia is associated with a high risk of early ischemic heart disease onset and cardiovascular death. There is almost no data about the prevalence of the disease in the Ukrainian population. The aim of the study was to assess the incidence of familial hypercholesterolemia among patients who were treated in “L.T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” due to early ischemic heart disease. Medical records data of 600 patients treated in the Institute during 2015-2017 were analyzed. Early ischemic heart disease was diagnosed in 89 patients. The disease verification has been conducted either on the basis of coronarography data, or on the basis of previous myocardial infarction with Q wave. To identify patients with familial hypercholesterolemia, the Dutch lipid clinic network criteria were used. The presence of familial hypercholesterolemia was suspected in more than 14.8% of patients with early ischemic heart disease. Among these patients, 2 (2.2%) had definite diagnosis; 27 (30.3%) were likely to have diagnosis, 26 (29.7%) had possible diagnosis and in 34 (38,2%) patients it was unlikely to diagnose them with familial hypercholesterolemia. The term “familial hypercholesterolemia” was not mentioned in the hospital diagnosis. This paper demonstrates that despite frequent occurrence of familial hypercholesterolemia, doctors’ alertness towards this disease has been noted to be quite low.

Objective — to assess the oxidative status and severity of inflammatory processes in patients with hypertension (AH) and subclinical hypothyroidism (SH) and their relationship to the rate of aging. Materials and methods. 98 patients (38 men and 61 women) of young and middle age with a median age of 48.3 years were examined. All patients were divided into 3 groups: controls — healthy volunteers (n = 20), comparison group — euthyroid patients with AH and signs of autoimmune thyroiditis (AIT) (n = 36); main group — patients with AH and SH with signs of AIT (n = 42). Thyroid parameters, markers of oxidative stress (total superoxide dismutase, T‑SOD, total antioxidant activity, TAA, total hydroperoxides, THP), inflammatory markers (C‑reactive protein, SRP, tumor necrosis factor‑alpha, TNF‑a) were evaluated in all patients. The rate of aging was determined by estimating the biological age and age delta according to the methods of A. G. Gorelkin, B. B. Pinhasov (BA1, dBA1 respectively) and V. P. Voitenko (BA2, dBA2, respectively), as well as by determining the content of sirtuin 1 (SIRT1). Results. Significant differences were found between the controls and the comparison group in the rate of aging by both methods (p < 0.05), between the control and the main group in the levels of CRP (p = 0.000), TNF‑a (p = 0.000), aging rates by both methods (p < 0.05), as well as between the comparison and the main groups in the values of CRP (p = 0.001), TNF‑a (p = 0.000), THP (p = 0.041), T‑SOD (p = 0.048), SIRT1 (p = 0.001), dBA2 (p = 0.030). Correlation analysis revealed a significant (p < 0.05) direct relationship between the rate of aging and the level of CRP, free thyroxine, THP, THP/TAA index, and the inverse relationship between the rate of aging and T‑SOD, TAA in the comparison group. A significant direct relationship (p < 0.05) between CRP and BA1, a direct relationship between TNF‑a and thyroid‑stimulating hormone (TSH) levels and a direct association of T‑SOD with TSH and inverse one with BA1 were found in the main group. Conclusions. Patients with AH have a decrease in the rate of aging and a significant increase in SIRT1 compared with euthyroid patients with AH, that indicates a probable association with a slowing of aging rates. A significant increase in THP and a decrease in and T‑SOD levels, along with the presence of a connection with TSH and BA1, indicates a violation of redox processes in this category of patients and its association with aging rates. Patients with AH and SH also showed signs of metabolic inflammation, which was confirmed by a significant increase in the levels of TNF‑a, CRP, as well as by the presence of a direct link between TNF‑a and TSH. BA and aging rates increased with increasing CRP levels in euthyroid patients with AH, but no association between CRP and TSH was observed.

No abstract