The purpose of the study was to assessment of the effectiveness of measures for modification of life style (LSM) and the development of differentiated approaches to the correction of the dietary factor in patients with hypertension disease with abdominal obesity of high and very high CVR. Material and methods. The authors conducted a questionnaire on the features of nutrition and the study of the possibilities of dietary intervention among 86 patients with essential hypertension (EH) of the II stages and the 2nd -3rd degrees with signs of MS. The comparison group consisted of 19 patients who did not receive dietary intervention. We used the Dietary Approaches to Stop Hypertension was as an adapted low-salt diet. Results and discussion. Dietary intervention (DI) in combination with antihypertensive therapy led to blood pressure (BP) and blood lipids target levels achievement, lowering of metabolic effects, normalization of blood pro inflammatory factors levels UA and CRP, carbohydrate homeostasis in terms of OGTT, to a greater percent than those who did not receive it. 95.2% of patients expressed their desire to continue their onset. In addition, 45.6% of patients receiving dietary intervention were able to reduce the dose and amount of antihypertensive drugs. In the dynamics of dietary therapy in all patients, we observed improvement in general, loss of headache, dizziness, palpitations, general weakness, fatigue, discomfort and pain in the area of the heart. After dietary therapy, there was a decrease in office pressure – SBP from (168.9 ± 4.6) to (138.1 ± 2.4) mm Hg and DBP from (99 ± 5) to (82 ± 7) mm Hg (p <0.05). In this category of patients, besides the probable decrease in SBP and DBP, there was a significant decrease in heart rate (HR): (89 ± 4) to (78 ± 3) sec-1 (p <0.05). In patients with EH with AO who did not receive DI, shifts in SBP, DBP and HR were also probable (p <0.05). Conclusions. Dietary nutrition is one of the leading links in the strategy of basic measures for LSM in patients with EH with AO. An optimal diet option for this category of patients with very high CVR should be influenced with the help of an adapted low-salt diet DASH. Approaches to correction of dietary therapy taking into account the pathogenetic characteristics and CVR of patients improve the quality and duration of their lives and serve as reliable means of primary prevention in persons with EH with AO. Subsequent long-term follow up of patients with EH with AO in conditions of DI and LSM will allow to objectively evaluate their effectiveness in preventive measures in this vulnerable category of patients.
Full text: PDF (Ukr) 208K