EFFECTIVENESS OF METABOLIC THERAPY IN A COMORBID STATE OF ARTERIAL HYPER-TENSION, OBESITY AND GOUT

The aim of the study: to evaluate the efficacy of meltedonium dihydrate on endothelial dysfunction indices, arterial stiffness and systemic immuno-suppression parameters in patients with arterial hyperten-sion combined with obesity and gout. Materials and methods of research. The study included 80 patients with EAG stage II, in combination with obesity and gout. The 1st subgroup - 20 patients receiving standard therapy: calcium channel blockers - amlodipine 5-10 mg/day, statin - atorvastatin 10-20 mg/day, netiazidic diuretic - indapamide 2.5 mg in the morning, allopurinol 100-300 mg/day .The 2nd subgroup - 20 patients who, in addition to standard therapy, re-ceived Meldonium dihydrate (Metamax, Darnitsa, Ukraine) - 5 ml of 10% solution was diluted in 15 ml of 0.9% sodium chloride solution, injected intravenously over 10 days, followed by transfer on the capsule form - 250 mg 3 times a day for 1 month inside. They performed a clinical examination of patients and identified EEVD, ENZVD, TIMK, SPPHC, CAVI, FHA, ET-1, SRP and IL-6 levels in the blood. Results of the research and their discussion. In assessing the level of autoimmune activation rates, no significant changes in IL-6 levels were observed. At the same time, the PSA level after treatment reduced both after a month of treatment and after 6 months of the same therapy. After 1 month, positive dynamics of EHP was observed at 68.92% (p<0.001), and after 6 months of treatment - by 70.81% (p<0.001). After a month of application of meltedonium dihydrate, the level of ET-1 decreased by 36.47% (p<0.001), and after 6 months - by 36.69% (p<0.001). Reliable IGA changes were absent (p>0.05). CAVI declined already after 1 month of treat-ment - by 6.32% (p<0.05), and after 6 months - by 8.24% (p<0.05). After 1 month of treatment, TIMK decreased by 13.46% (p <0.05), and after 6 months - by 16.34% (p<0.01). TPPH also significantly decreased after 12 months (12.54%) (p<0.01), and 6 months at 18.31% (p<0.001). No significant changes in IL-6 levels were observed, and the PSI level after one month of treatment decreased by 9.22% (p<0.01), and after 6 months - by 11.48% (p<0.001). Conclusions. Meltedonium dehydrate admin-istration in standard therapy leads to effective not only antihypertensive, but also anti-inflammatory and vasoprotective action.