The most common articular pathology is osteoarthrosis of the knee joints. More than 10 % of the world's population suffers from this disease. The development of osteoarthrosis (OA) is also affected by metabolic syndrome (MS), which is characterized by abdominal obesity, dyslipidemia, arterial hypertension and disturbance of carbohydrate metabolism. The combination of MS and osteoarthrosis creates conditions of overload for the functioning of axial joints, which is one of the main causes of premature disability and invalidization of the population. Treatment of OA of the knee joints in women in the menopausal period with concomitant metabolic syndrome presents great difficulties. To achieve a stable result of treatment, therapy with chondroprotectors and nonsteroidal anti-inflammatory drugs (NSAIDs) is used. Treatment was carried out in 60 women in the menopausal period with MS, suffering from OA of knee joints. In the group of women in the menopausal period with OA of knee joints and MS who took therapy with the inclusion of the soybean and avocado drug alongside with NSAIDs, a significant effect was obtained with regard to arresting the pain syndrome, improving the quality of life, reducing the degree of inflammation as well as increased joint mobility compared with the group of patients, who took only chondroprotectors and NSAIDs

Сьогодні проблема виявлення та лікування хворих на атеросклероз, головним чином, полягає в тому, що немає всеукраїнської програми боротьби з цією хворобою, скринінгу рівня холестерину та інших факторів ризику, відсутністні достатня інформованість населення з питаннь данного фаху та підтримка у засобах масової інформації, неефективність судинних центрів щодо зниження летальності, недостатня прихильність пацієнтів до лікування, недосягнення цільових рівнів ліпопротеїнів низької щільності та притаманний страх призначення максимальних доз статинів. В останнє десятиріччя багато даних накопичено стосовно захворювань із сімейною гіперхолестеринемією, та достоіменно відомо, що поширеність їх виявилась частішою, ніж очікувалась попередньо. Сімейна гіперхолестеринемія – це спадкове захворювання, що асоціюється з раннім розвитком агресивного атеросклерозу та серцево-судинних захворювань у молодому віці, що характеризується тяжким перебігом та високою летальністю. У статті викладено оглядові дані сучасного стану епідеміології, профілактики та керування пацієнтів із сімейною гіперхолестеринемією, акцентовано увагу на раннє виявлення хворих та скринінгу сім’ї.

The high prevalence of arterial hypertension (AH) and concomitant obesity in young patients is not only a medical but also a social problem. It is important to develop additional modern approaches to the management of young patients with AH and obesity, which will increase the effectiveness of existing antihypertensive (anti-AH) medical therapy and prevent early damage of target organs and complications. The purpose of the research was to evaluate the antihypertensive efficacy of the proposed complex treatment and its impact on quality of life in young patients with AH and obesity (or overweight). Material and methods 123 patients with AH (ESC 2018), of young age 18–44 (mean age 32.81±0.58) y.o. were examined, among them the overweight was in 40 patients, obesity - in 42 patients. The average BMI was (28.34±0.45) kg/m2. All patients were divided into 2 groups depending on the treatment: Group 1 – standard anti-AH treatment, Group 2 – modified combined therapy, which included on the background of standard anti-AH medications the dosed controlled physical exercises with its obligatory registration, a modified DASH diet with increased intake of Ca-containing products and Metformin in the presence of insulin resistance according to the HOMA index (with correction of dose depending on BMI). In dynamics the patients were performed daily blood pressure monitoring (BPM) was performed and the SF-36 questionnaire was used to assess the quality of life (QOL). Results and discussion According to BPM data in the Group 1 the average 24-hour value of SBP decreased by 12.5% (p=0.01), in Group 2 – by 20.2% (p=0.001), DBP - by 11.2% (p=0.03) and by 18.8% (p=0.01) respectively (the difference between the groups for SBP and DBP was p=0.032 and p=0.041, respectively). Assessing the degree of nocturnal blood pressure decreasing, in the Group 1 the percentage of patients with insufficient nocturnal blood pressure decreasing (non-dipper) and stable increasing (night peaker) decreased non-significantly (p=0.086), unlike the Group 2, where there was a significant (p=0.02) positive dynamics in relation to these unfavorable types of blood pressure profile. Evaluating the indicators of QOL according to SF-36, the physical component of health in the Group 1 increased by 16.7%, in Group 2 – by 33.4% (p=0.001), the mental component of health – by 13.5% and 28.9%, respectively (p=0.001). Thus, the additional use of the proposed treatment complex with the inclusion of dosed registered exercises, increased consumption of Ca-containing products and correction of insulinresistance significantly increases the effectiveness of antihypertensive medical therapy and has a positive effect on physical and mental components of QOL in young patients with AH and obesity or overweight. Funding Acknowledgement Type of funding sources: None.

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