INTRODUCTION. The therapeutic strategies for managing patients with comorbid conditions, such as arterial hypertension (AH) and prediabetes, are widely adopting non-drug methods along with the recommended medications. AIM. To evaluate the effect on fat distribution and humoral status of sulfide balneotherapy in the conditions of the experiment on white rats and clinical study of AH and prediabetes patients. MATERIAL AND METHODS. The study was of a clinical and experimental nature and consisted of 2 phases – experimental and clinical. The experimental study was carried out on obese, non-pedigreed white rats. Animals were exposed to sulfide baths and a combination of sulfide applications and baths. In the clinical phase of the study, patients with AH and prediabetes were included. All patients included in the present study received standardised drug therapy according to clinical guidelines, and patients in the observation group additionally received combined sulphide balneotherapy (Suksun lake sulphide applications and baths) for 14 days. The study program included assessment of weight, waist circumference (WC), body mass index (BMI), assessment of serum concentrations of vascular endothelial growth factor (VEGF); tissue growth factor (TGF b), insulin and leptin, as well as determination of epicardial fat thickness (EFT). RESULTS AND DISCUSSION. The experimental conditions revealed lipolysis in adipocytes (omentum), as well as an increase in the number of hemocapillaries in all areas of the heart and the growth of CD34 expression. The results of the clinical stage of the study suggest redistribution of fat depots against the background of sulfide balneotherapy. There were no statistically significant differences in weight and BMI in the dynamics, but there was a significant decrease in OT and TEF in the group of patients who received balneotherapy, who also had a significant decrease in HEFR concentration, leptin and an increase in TEFR beta 1. CONCLUSION. The presence of lipolytic, regenerative and adipokine-regulating effects of sulfide balneotherapy was demonstrated in the experiment and clinical study.

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Currently, cardio rehabilitation is part of the General system of medical care, whose task is to improve the quality of life and maximize the recovery of the patient’s habitual lifestyle. Therefore, it is advisable to include patients with cardiological pathology in rehabilitation programs. Despite the success achieved in recent years in the treatment, prevention and rehabilitation of patients with coronary heart disease (CHD), the search for new and more advanced methods of cardio rehabilitation in this category of patients remains an urgent task.

The review analyzes the data of scientific publications on the effects of molecular mechanisms initiated by physical exertion on thefunction of the cardiovascular system and the course of cardiac diseases. As practice and a number of evidence-based studies haveshown, the beneficial effects of physical activity on the outcomes of diseases in a number of cardiac nosologies are comparable todrug treatment. Numerous mechanisms mediate the benefits of regular exercise for optimal cardiovascular function. Exercises causewidespread changes in numerous cells, tissues, and organs in response to increased metabolic demand, including adaptation of thecardiovascular system. Physical exercises, which include various types of aerobic exercises of varying intensity and duration, is animportant component of the therapeutic treatment of patients with cardiovascular diseases. Knowledge of the molecular basis ofthe physical activity impact on the cardiovascular system makes it possible to use biochemical markers to assess the effectiveness ofrehabilitation programs.

The review shows that the molecular mechanisms initiated by physical exertion underlie the multifactorial influence of the latter on the function of the cardiovascular system and the course of cardiac diseases. Exercise is an important component of the therapeutic treatment in patients with cardiovascular diseases, which is confirmed by the results of a meta­analysis that included 63 studies that were associated with various forms of aerobic exercise of different intensity (from 50 to 95 % VO2) for 1 to 47 months, which showed that exercise-based CR improves cardiovascular function. Knowledge of the molecular basis of the impact of physical activity makes it possible to use biochemical markers to assess the effectiveness of rehabilitation programs.