Every year in the world, arterial hypertension is the cause of death in about 9 million cases. Blood pressure control in patients has not yet reached the appropriate level, and the percentage of resistant arterial hypertension remains high. According to the definition of the American Heart Association, those patients whose condition requires taking four or more drugs to control blood pressure should be considered resistant to treatment. It should be understood that uncontrolled hypertension is not synonymous with RAH. The presence of RAH significantly increases the risk of cardiovascular complications, contributes to serious damage to target organs. Preliminary diagnosis of RAH definitely requires the exclusion of secondary hypertension, which is a rather heterogeneous group of diseases that is poorly recognized. The goal of the work. To acquaint general practice - family medicine doctors with the algorithm of treatment of patients with resistant arterial hypertension at the ambulatory stage. Treatment of patients with RAH should be carried out in stages, with increased therapy, using the most simplified scheme of taking drugs. Today, the combination of ACEI (perindopril), BCC (amlodipine) and diuretic (indapamide) is considered as the most optimal triple combination of antihypertensive drugs. Medicines containing three antihypertensive drugs in one tablet are offered precisely for RAH patients. Conclusions. The implementation of the algorithm for the examination of patients with RAH, recommendations for changing their lifestyle and a step-by-step therapy plan allow improving the control of blood pressure. Treatment of patients with RAH should include optimization of dosages and the appointment of rational combinations of antihypertensive drugs in order to enhance synergistic effects. Optimization of pharmacotherapy by prescribing drugs with fixed combinations can improve control of drug administration. The fixed combination of amlodipine-indapamide-perindopril may have the important advantage of increasing treatment adherence due to the principle of "one pill per day".

One of the important problems of modern medicine is the continuous increase of cardiovascular disease. An urgent problem at the present stage is the treatment of patients with acute forms of coronary heart disease, since vascular accidents are the leading causative factors of mortality from cardiovascular disease. Recently, an increasing number of studies have determined the role of genetic markers for predicting the adverse course of various cardiovascular diseases, including acute myocardial infarction. The distribution of genes markers of systemic inflammatory responses was determined in patients with STEMI. There are riteria for inclusion in the study: male and female patients from 46 to 75 years old; for postmenopausal women, more than 1 year; the presence of STEMI in the first 12 hours of the onset of the disease; informed consent of the patient to participate in the study. DNA was isolated from leukocytes from whole blood using the Express DNA Blood Kit (Litech). In the process of DNA extraction, the recommendations given in the kit instructions were followed. SNP polymorphisms of C-reactive protein genes were determined G-3014>A, tumor necrosis factor-α G-308>A, interleukin-10 G-1082>A by real-time polymerase chain reaction using a Rotor-Gene 6000 thermocycler (Corbett Research, Australia). The structure of the primers from the standard SNP-express-PB sets (Litech) was used. It was determined, that in patients with STEMI, an increase in the proportion of homozygotes (GG) and a decrease in heterozygotes (GA) of the genotypes of the G-3014>A polymorphism of the C-reactive protein gene are determined in comparison with the Hardy–Weinberg distribution. Polymorphism G-308>A of the tumor necrosis factor-α gene among patients with STEMI had a significant discrepancy with Hardy–Weinberg equilibrium, with an increase in the proportion of homozygotes (GG) and a decrease in heterozygotes (GA) and homozygotes (AA). The distribution of G-1082>A polymorphism of the interleukin-10 gene was characterized by an increase in the proportion of homozygotes (GG) and a decrease in heterozygotes (GA) in patients with STEMI compared to the Hardy–Weinberg distribution.

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DOSE-DEPENDENT EFFECT OF STATINS ON THE PASSAGE OF CHD AMONG PATIENTS AFTER PRIMARY MYOCARDIAL INFARCTION