scholarly journals The use of telmisartan in patients with refractory arterial hypertension and obesity

2019 ◽  
Vol 18 (1) ◽  
pp. 73-81 ◽  
Author(s):  
I. Е. Deneka ◽  
A. V. Rodionov ◽  
V. V. Fomin
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Ace Inhibitor ◽  
Enzyme Inhibitor ◽  
Blood Pressure Monitoring ◽  
Main Group ◽  
Control Group ◽  
Angiotensin Ii Receptor Blocker ◽  
End Point

Aim.To evaluate the effectiveness of telmisartan as a component of triple antihypertensive therapy in patients with obesity and refractory arterial hypertension.Material and methods.The study included 30 patients with obesity and refractory arterial hypertension. All patients received an angiotensin II receptor blocker (ARB) or an angiotensin-converting enzyme inhibitor (ACE inhibitor) in an adequate dosage as part of a triple antihypertensive therapy that also includes a calcium antagonist and thiazide diuretic. Participants were randomly divided into two equal groups. In the main group, telmisartan (Dr. Reddy’s Laboratories) was prescribed at a dosage of 80 mg/day instead of the previously taken ARB or ACE inhibitor. In the control group, patients continued to receive a previously prescribed ARB or an ACE inhibitor. The primary end point was a decrease in mean daily systolic and/or diastolic blood pressure (SBP and DBP) according to 24-hour blood pressure monitoring at 10 mm Hg and more than 20 weeks after the start of the study. The secondary end point was a decrease in the concentration of inflammatory markers and an increase in the level of adiponectin by 15%.Results.After 20 weeks, in the telmisartan group, we noted a significant decrease in the average daily SBP and DBP: in the main group from 145,9±5,4/95,6±4,8 mm Hg to 134,8±3,0/84,9±4,2 mm Hg, in the control group with 147,2±4,9/96,4±5,6 mm Hg to 142,4±4,3/96,9±62 mm Hg. We also determined an increase in the serum adiponectin concentration from 9,3±5,6 μg/ml to 13,4±6,6 μg/ml in the main group and a decrease from 8,8±5,2 μg/ml to 8,6±5,6 μg/ml in the control group, as well as a decrease in the concentration of highly sensitive C-reactive protein (main group from 8,8±3,0 to 6,0±2,8 mg/l and the control group from 7,4±3,8 to 6,9±4,9 mg/l) and interleukin-6 (main group from 16,2±6,1 to 12,3±2,8 pg/ml, control group from 22,5±4,2 to 19,9±5,2 pg/ml).Conclusion.Telmisartan can be considered as a drug of choice as part of multi-component therapy in the treatment of patients with obesity and refractor arterial hypertension.

scholarly journals Current Guidelines for the Treatment of Arterial Hypertension in Patients with Diabetes Mellitus and Chronic Kidney Disease

2021 ◽  
Vol 17 (2) ◽  
pp. 323-331
Author(s):  
T. Yu. Demidova ◽  
O. A. Kislyak
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Enzyme Inhibitor ◽  
Angiotensin Ii Receptor Blocker ◽  
Prevention And Treatment ◽  
Patients With Diabetes

The current understanding of the management of patients with diabetes mellitus (DM) based on the concept of the cardiovascular continuum involves not only the prevention and treatment of cardiovascular diseases (CVD), but also the prevention and treatment of chronic kidney disease (CKD). The fact is that patients with DM and CKD represent a special group of patients with a very high risk of CVD and cardiovascular mortality. Such patients require early diagnosis and timely identification of risk factors for the development and progression of CKD for their adequate correction. Arterial hypertension, along with hyperglycemia, is the main risk factor for the development and progression of CKD in patients with diabetes. In this regard, the choice of antihypertensive therapy (AHT) in patients with diabetes is of particular importance. The basis of AHT in diabetes and CKD is the combination of a blocker of the renin-angiotensin-aldosterone system (an angiotensin-converting enzyme inhibitor [ACE inhibitor] or an angiotensin II receptor blocker [ARB]) and a calcium channel blocker (CCB) or a thiazide / thiazide-like diuretic. The task of the performed AHT is to achieve the target level of blood pressure (BP). At the same time, the optimal blood pressure values in patients with diabetes and CKD are blood pressure values in the range of 130-139/70-79 mm Hg. If the target blood pressure is not achieved, it is necessary to intensify antihypertensive therapy by adding a third antihypertensive drug to the therapy: CCB or a diuretic (thiazide / thiazide-like or loop). In case of resistant hypertension, it is necessary to consider the possibility of adding antagonists of mineralocorticoid receptors, other diuretics or alpha-blockers to the conducted AHT. Beta-blockers can be added at any stage of therapy if the patient has exertional angina, a history of myocardial infarction, atrial fibrillation, and chronic heart failure. The need to normalize blood pressure parameters by prescribing combined antihypertensive therapy in patients with diabetes and CKD is explained by a decrease in renal and cardiovascular risks, and, therefore, a decrease in the risk of mortality in this cohort of patients.

scholarly journals Prevalence of Arterial Hypertension and Characteristics of Nocturnal Blood Pressure Profile of Asthma Patients According to Therapy and Severity of the Disease: The BADA Study

2020 ◽  
Vol 17 (18) ◽  
pp. 6925
Author(s):  
Domenico Di Raimondo ◽  
Gaia Musiari ◽  
Alida Benfante ◽  
Salvatore Battaglia ◽  
Giuliana Rizzo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Pressure Profile ◽  
Control Group ◽  
Cardiovascular Comorbidities ◽  
Cardiovascular Damage ◽  
Increased Risk ◽  
Asthma Patients ◽  
Severity Of The Disease

Background: several studies report an increased risk for asthmatic subjects to develop arterial hypertension and the relationship between these two diseases, frequently co-existing, still has some unclear aspects. Methods: The BADA (blood pressure levels, clinical features and markers of subclinical cardiovascular damage of asthma patients) study is aimed to evaluate the prevalence of the cardiovascular comorbidities of asthma and their impact on the clinical outcome. The main exclusion criteria were the presence of other respiratory diseases, current smoking, any contraindication to ambulatory blood pressure monitoring (ABPM). Results: The overall percentage of asthmatics having also hypertension was 75% (30 patients) vs. 45% (18 patients) of the control group (p: 0.012). Reduced level of FEV1 (but not inhaled steroid therapy) was associated to newly-diagnosed hypertension (p: 0.0002), higher day SBP levels (p: 0.003), higher day DBP levels (p: 0.03), higher 24 h-SBP levels (p: 0.005) and higher 24h-DBP levels (p: 0.03). The regression analysis performed taking into account sex, age, diabetes, fasting glucose, and body mass index confirms the independent role played by asthma: odds ratio (OR): 3.66 (CI: 1.29–11.1). Conclusions: hypertension is highly prevalent in asthma; the use of ABPM has allowed the detection of a considerable number of unrecognized hypertensives.

scholarly journals The effectiveness of combination antihypertensive therapy in patients with arterial hypertension and additional risk factors: obesity and obstructive sleep apnea syndrome

2018 ◽  
Vol 90 (12) ◽  
pp. 28-33 ◽  
Author(s):  
E M Elfimova ◽  
A Yu Litvin ◽  
I E Chazova
Keyword(s):  
Blood Pressure ◽  
Sleep Apnea ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Fixed Combination ◽  
Blood Pressure Monitoring ◽  
Target Blood Pressure ◽  
Effective Control ◽  
Pressure Monitoring ◽  
Male Patients

Aim. To study the effectiveness of a fixed combination of perindopril and amlodipine, with the subsequent addition of indapamide-retard in male patients with arterial hypertension (AH), obesity and severe sleep apnea (OSAS). Materials and methods. The study included 43 male patients in whom antihypertensive therapy titration was performed to achieve target blood pressure values with a fixed combination of calcium antagonist amlodipine (10 mg) and an angiotensin-converting inhibitor perindopril (5-10 mg) and indapamide-retard. At baseline and after 4-6 weeks, the effectiveness of antihypertensive therapy was monitored according to clinical measurements and ambulatory blood pressure monitoring (ABPM). An assessment of the carotid-femoral pulse wave velocity (cfPWV), aortic PWV (aoPWV), and ankle-brachial PWV (abPWV) was performed. Results and discussion. Target blood pressure values (according to clinical blood pressure, 24-hour blood pressure monitoring) during therapy with amlodipine 10 mg and perindopril 10 mg reached 65% of patients and another 30% reached target blood pressure when adding indapamide-retard 1.5 mg, that is - 95% of all patients included in the study. Upon reaching the target blood pressure values, a significant decrease in cfPWV, aoPWV and abPWV was observed. Conclusion. The fixed combination of perindopril arginine and amplodipine, with the addition of indapamide retard in male patients with hypertension 1st degree in the presence of obesity and severe OSAS allows to reach effective control of blood pressure and improve the elastic properties of large arteries, which can lead to a favorable organoprotective effect in this category of patients.

scholarly journals EVALUATION OF CARDIOVASCULAR DYSREGULATION IN PATIENTS AFTER HEMORRHAGIC STROKE AS A COMPLICATION OF ESSENTIAL HYPERTENSION

2021 ◽  
Vol 125 (3) ◽  
pp. 32-43
Author(s):  
Oleksandr Tkachyshyn
Keyword(s):  
Blood Pressure ◽  
Traumatic Brain Injury ◽  
Essential Hypertension ◽  
Brain Injury ◽  
Systolic Blood Pressure ◽  
Mild Traumatic Brain Injury ◽  
Hemorrhagic Stroke ◽  
Blood Pressure Monitoring ◽  
Main Group ◽  
Control Group

The aim of the study was to compare blood pressure and electrocardiogram indices, assessed by their daily monitoring, and anamnestic data on mild traumatic brain injury between a group of patients with essential hypertension ≥6 months after a hemorrhagic stroke and a group of patients with essential hypertension without complications. Materials and methods. The total number of examined patients was 198 people, who were divided into 2 groups: the main (n = 94; age – 54,4±8,8 years, M±σ years) and the control (n = 104; age – 53,7±8,9 years) one. Patients in the main group suffered a hemorrhagic stroke as a complication of essential hypertension ≥6 months ago. The control group included patients with essential hypertension, stage II. In both groups of patients, the parameters of 24-hour ambulatory blood pressure monitoring and electrocardiogram were determined. Results. The indices of 24-hour ambulatory blood pressure monitoring in the main group and the control group were the following ones, respectively: the mean daytime systolic blood pressure was 109,6±1,6 and 121,1±1,1 mm Hg, the minimal one was 74,4±2,0 mm Hg and 82,3±12,5 mm Hg, and the maximal one was 168,2±1,9 and 161,9±1,7 mm Hg, p<0,05. The daytime sigma systolic blood pressure (17,9±0,6) and its average real variability of (11,31±2,52 mm Hg) were bigger in the main group (p<0,05). The daytime index of the hyperbaric load of systolic blood pressure was bigger in the main group: it was 403,6±25,9 against 231,7±12,1 mm Hg×h in the comparison group (p<0,05). The mean, minimum and maximum heart rate at night were significantly lower in the main group (p<0,05). The QTcmin index was significantly lower in the main group in contrast to the control one – 286,28±43,34 and 336,69±22,55, and the QT variance was greater – 232,56±44,55 –  in comparison to the control group (188,31±33,67) (p<0,05). From the anamnestic data of patients, a significantly higher prevalence of mild traumatic brain injury was found in 37,4% (35 patients out of 94) in the main group relative to the control one – 13,5% (14 out of 104), p<0,05. Conclusions: The results of the study indicate the larger ranges of blood pressure variability in patients with essential hypertension complicated with hemorrhagic stroke, which can be caused by impaired autoregulation according to the QTc interval data. In combination with the disturbances of cerebral circulation, caused by the injury of the brain due to the hemorrhagic stroke alone or in combination with mild traumatic brain injury episode, such a situation may lead to the development of recurrent stroke.

scholarly journals The condition of parameters of memory, attention and thinking at men of young age officers under the contractwith arterial hypertension.

2009 ◽  
Vol 6 (4) ◽  
pp. 59-63
Author(s):  
Il'ya Mikhaylovich Davidovich ◽  
Oleg Vladimirovich Afonaskov ◽  
Yuliya Konstantinovna Staroverova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Control Group ◽  
Military Officers ◽  
Pressure Data ◽  
Pressure Profiles ◽  
Blood Pressure Data ◽  
Stage 1 ◽  
Made In

Aim: to evaluate memory, attention and thinking functions indices in young hired military officers depending on their 24-hours blood pressure profiles. Materials and methods. The study was made in 49 patients with stage 1-2 arterial hypertension, aged 39,3±0,8, who did not take hypotensive medicines or took them occasionally. 24-hours blood pressure monitoring was performed with assessment of cognitive functions (memory, attention) depending on the stage, degree and duration of the disease. The control group included 12 men with no signs of arterial hypertension. Results. Comparing with the controls the memory, attention and thinking indices in hypertonic patients were found to be lower .even in those who had the first degree of hypertension and duration of the disease less than 5 years. The hypertonic patients showed lowering of attention and semantic memory scopes irrespective of duration of the disease. There was a negative correlation between monitored blood pressure data and memory, attention and thinking indices. Conclusions. Light cognitive dysfunctions can be found in young hired military officers with initial arterial hypertension but they are more typical for stage 2 of the disease

scholarly journals Congenital immunity in patients with essential arterial hypertension and effectiveness of antihypertensive pharmacotherapy

2020 ◽  
pp. 27-33
Author(s):  
Vadim P. Mikhin ◽  
Evgenia V. Gavrilyuk ◽  
Irina V. Evsegneeva
Keyword(s):  
Blood Pressure ◽  
Innate Immunity ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Complement System ◽  
Control Group ◽  
Target Values ◽  
Essential Arterial Hypertension ◽  
Group 2 ◽  
The Complement System

The purpose of the study was to assess the parameters of innate immunity in patients with essential arterial hypertension and to establish a relationship with the effectiveness of antihypertensive pharmacotherapy. Materials and methods. The study included 48 patients with essential arterial hypertension stage II, arterial hypertension 2 degree and hypertrophy of the left ventricular myocardium, which were divided into 2 groups: the first group (25 patients) - these are patients whose blood pressure reached the target values, and the second group (23 patients) are patients whose blood pressure did not reach the target values against the background of antihypertensive therapy (perindopril - 5 mg/day and amlodipine - 5 mg/day) (group 2). Indicators of 18 healthy donors were used as a comparison group (control group). Results. In patients with essential arterial hypertension of group 1, compared with the control group, the concentration of IL-1α, IL-6, IL-8, IL-10, IL-1 receptor antagonist, IL-2, C4- and C5a-components of the complement system and factor H is significantly higher and the level of C3 is lower-component of the complement system. In patients with essential arterial hypertension of group 2, more pronounced changes in the cytokine link of the immunity and the complement system were established before the start of antihypertensive therapy. After the antihypertensive therapy in patients with essential arterial hypertension of the 1st group in the blood plasma, the concentration of TNF, IL-1α, IL-8, IL-10, IL-1 receptor antagonist significantly decreased, but not to the values of the control group, and in patients of the 2nd group, the effectiveness of antihypertensive therapy in correcting parameters innate immunity was found to be less effective. Conclusion. Revealing the participation of innate immunity indicators in the formation of arterial hypertension opens up new possibilities for the pathogenetic therapy of this disease and developing measures to prevent or level the damage to target organs.

scholarly journals EFFECTIVENESS OF APPLICATION OF TELEMONITORING OF BLOOD PRESSURE IN PATIENTS WITH NORMAL WEIGHT AND OVERWEIGHT

2021 ◽  
Vol 121 (1) ◽  
pp. 32-42
Author(s):  
Inna Berdnyk
Keyword(s):  
Blood Pressure ◽  
Primary Care Physicians ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Normal Weight ◽  
Main Group ◽  
Control Group ◽  
Adherence To Treatment ◽  
Pressure Monitoring ◽  
Number Of Patients

The article summarizes the arguments and counterarguments within the scientific discussion on the methods of diagnosing hypertension and features of blood pressure control. The main purpose of this study is to evaluate the effectiveness of blood pressure monitoring in patients with normal weight and overweight and to determine their level of adherence to treatment. The relevance of the study about this pathology is that hypertension is the leading cause of cardiovascular disease and premature death worldwide. The prevalence of hypertension among the adult population is 30-45%, in 2018 the number of patients with hypertension in the world was about 1.38 billion, with more than 165 million living in Central and Eastern Europe. Systematization of literature data showed that despite the widespread use of antihypertensive drugs, only about 30% of patients have optimal blood pressure. The methodology of the study is to evaluate the use of telemedicine technologies for self-monitoring of blood pressure in patients with normal weight and overweight and increase their compliance. The study was conducted in Kyiv, Ukraine during 2018-2020, and included 111 patients aged 18 to 65 years with a previously diagnosed hypertension. By randomization, they were divided into the main group (used blood pressure monitoring) and the control group (used office and home blood pressure monitoring). The article presents the results that in the patients of the main group at the end of the study the average daily systolic and diastolic blood pressure were significantly lower in comparison with both the initial level of the group and in comparison with the control. The baseline adherence to treatment in patients in both groups was low. However, at the end of the study, the adherence of patients in the main group to treatment increased by 40.3%, while in the control group no significant changes were detected. In addition, a correlation was found between patients with overweight and less adherence to regular medication, more frequent skipping of the drug and self-withdrawal with improvement compared to patients with normal body weight. It was also noted that the patients in the main group at the end of the study significantly reduced the level of anxiety compared with the control. The study empirically confirms and theoretically proves that the use of blood pressure telemonitoring can be considered as an alternative to the standard approach that increases adherence to treatment. The results of the study will be useful for primary care physicians, cardiologists, therapists.

scholarly journals Influence of altiazem pp-180 on hemodynamic parameters in arterial hypertension patients under outpatient conditions

2018 ◽  
Vol 17 (3) ◽  
pp. 360-368
Author(s):  
Gulzhakhan Ryskalievna Zhakiyeva ◽  
Lyubov Muratovna Tulegenova ◽  
Nuria Zakarievna Ibragimova ◽  
Saubet Molbaevich Kelimberdiyev ◽  
Kulsin Kolganatovna Tokbayeva
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Hypertension ◽  
Blood Circulation ◽  
Day Treatment ◽  
Medical Science ◽  
Hypotensive Effect ◽  
Main Group ◽  
Control Group ◽  
Circulation Parameters

Background: The objective is to study the time-dependent hemodynamic effects of altiazem PP-180 and the blood circulation parameters in patients with arterial hypertension of the II degree in outpatient polyclinic conditions.Methods: The study included 78 patients with essential II grade AH aged 42 to 73 years (mean age of 57.65 ± 0.6). Among them were 28 men and 50 women. The duration of the disease ranged from 4 to 23 years (an average of 9.2 ± 0.12). All the groups involved in the research were divided into two subgroups: the main group and the control group. The control group included 30 patients, who took A-180 once a day at non-fixed hours. The main group included 48 patients, who were divided into random subgroups depending on the time they took A-180 once a day. Within 3 days prior to treatment and during the 10-day treatment course, the medical staff measured all the pateints’ heart rate and blood pressure by NC Korotkoff every 3 hours, 6 times a day. The patients’ heart rate and blood pressure were alternatively self-measured. Prior to treatment and at the end of the 10-day course of therapy with altiazem PP-180, all the patients involved in the research underwent ECG examination and echocardiography on the Aloka machine (Japan).Results: The most favorable hemodynamic support for the hypotensive effect of altiazem PP-180 was observed when patients took it at 7 a.m., 10 a.m. and 10 p.m. in their normal mode of work and rest. When patients took altiazem PP-180 at 1 p.m, 4 p.m. and 7 p.m., its hypotensive effect was due to less favorable hemodynamic support.Conclusions: When taken at different hours of the day - both fixed and non-fixed hours - altiazem PP-180 caused a distinct hypotensive effect in patients with the II degree AH in outpatient polyclinic conditions.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.360-368

scholarly journals Predicting the risk of left ventricular hypertrophy in children and adolescents with arterial hypertension on the basis of 24-hour blood pressure monitoring and metabolism indicators

2020 ◽  
Vol 1 ◽  
Author(s):  
Tamara Haiduk ◽  
Olha Haiduk ◽  
Irene Gubar
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Hypertrophy ◽  
Arterial Hypertension ◽  
Children And Adolescents ◽  
Ventricular Hypertrophy ◽  
Blood Pressure Monitoring ◽  
Left Ventricular ◽  
Control Group ◽  
Immunoreactive Insulin ◽  
Pressure Monitoring

Abstract: Objective: To investigate the significance of 24-hr ambulatory blood pressure monitoring (ABPM) data and metabolism indicators, as well their correlation in predicting the risk of left ventricular hypertrophy (LVH) in children and adolescents with arterial hypertension (AH). Methods: We studied 118 children and adolescents, M±m 15.51±0.25 yrs, Boys/Girls – 104/14, with AH: 60 stable, 40 labile, 18 prehypertension (high-normal blood pressure), and a control group of 13 normotensive children, M±m 15,19±0,41 yrs, Boys/Girls – 10/3. All patients underwent a comprehensive anamnestic, clinical, laboratory, and instrumental examination, including 24-hr ABPM; indicators were standardized by gender and age. On Doppler echocardiography (echoCG), the left ventricular myocardial mass index (LVMI) was calculated. Lipid spectrum parameters were determined by biochemical method, venous blood glycemia by GOD-PAP, blood serum basal immunoreactive insulin by ELISA methods, insulin resistance (IR) by HOMA parameters calculation. Statistical processing was performed using the package of statistical analysis software STATISTICA. Results: Of a range of metabolism indicators, BMI, TG level, LDL/HDL ratio, HOMA index, 24-hr DBP index, and the stable character of AH identified as the most significant factors in predicting the risk of LVH in hypertensive children. All multivariate models of logistic regressions, which include BMI, can predict the probability of LVH with an accuracy of 79.7-84.7%, sensitivity - 57.5-77.5%, specificity - 86.4-91.0%. Conclusions: Obtained satisfactory concordance of the actual data with predictive models' results indicate the possibility of their use to predict the risk of LVH in children and adolescents with AH.

scholarly journals The comparative effects of different fixed combinations of antihypertensive drugs in patients with arterial hypertension and hypothyroidism

2020 ◽  
Vol 27 (4) ◽  
pp. 35-44
Author(s):  
V. I. Tseluyko ◽  
D. A. Korchagina
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Myocardial Mass ◽  
Pressure Monitoring ◽  
Heart Remodeling ◽  
Group 2

The aim – to assess the effects of different fixed double combinations of antihypertensive drugs and analyze their impact on heart remodeling in patients with arterial hypertension and hypothyroidism. Materials and methods. The study included 50 patients with hypertension and hypertension, which were divided into 2 groups by the method of blind envelopes of 25 people each. Patients in group 1 were assigned a fixed combination of perindopril with indapamide, patients in group 2 were assigned a fixed combination of perindopril with amlodipine. The groups were statistically compared by age, duration of hormonal substitution therapy, duration of hypertension, level of office SBP, DBP at inclusion in the study. In terms of body mass index, the study groups were comparable, but the number of obese patients was higher in group 2 (p=0.05). Observation of patients lasted 12 months.Results and discussion. The studied fixed combinations of antihypertensive drugs, namely perindopril with indapamide and perindopril with amlodipine provide a reduction in blood pressure in patients with hypertension with concomitant hypothyroidism according to the results of ambulatory blood pressure monitoring. Control of blood pressure in patients with arterial hypertension and concomitant hypothyroidism during a year of antihypertensive therapy provides a reduction in the severity of heart remodeling, the nature and extent of which depends on both the presence of obesity and the choice of a fixed combination of antihypertensive drugs.Conclusions. The results showed that in patients with AН and hypothyroidism achievement of euthyroid state contributes to BP reduction, but requires further administration of antihypertensive therapy. We studied fixed combinations of antihypertensive drugs, namely perindopril with indapamide and perindopril with amlodipine in patients with AG and associated hypothyroidism provide reliable blood pressure reduction according to the results of outpatient blood pressure monitoring (р<0.05). The fixed combination of perindopril with amlodipine compared with the fixed combination of perindopril with indapamide provides a significantly more significant effect on the regression of left ventricular myocardial hypertrophy, namely, a decrease in myocardial mass index by a degree of 2.7 in patients with obesity (р<0,01) myocardial mass index by body surface area in patients without obesity (p=0.06).

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