Nowadays, scientists and doctors are increasingly paying attention to the study of the cardinal problem of modern clinical medicine, comorbidity and polymorbidity, which may arise as a result of common etiology, pathogenesis, cause and effect influences (the syntopic impairments) or as an accidental combination of disease (the accompanying impairments) with age factor, anatomical closeness of the affected organs or accidental combination of diseases. The aim: to define the concomitant diseases and their course, which are most often observed in patients with CHD. The prospective study involved 100 patients with coronary heart disease: stable angina, І-ІV NYHA Class, І-II HF. Results and discussion. The incidence of combined pathology in patients with CHD increases with age: in group I, one of the comorbid conditions prevails (mainly gastrointestinal tract diseases), in group II and III, there are two or more concomitant diseases. Among the total number of patients, 95% live in the city, hence the result of the urbanization process, and only 5% live in the village. The analysis of medicines prescriptions, used in the treatment of patients with CHD revealed an increased use of larger amounts of drugs in age group III (≥60) as compared to groups I (≤40) and II (41-60). Adequate combined prescriptions of medicines to patients with comorbid conditions will allow us not only to prevent progression of each disease, but also to improve the long-term prognosis. Essential hypertension is the «leader» in the total number of comorbid diseases, which makes up 77% of patients among the total number of subjects, with the highest incidence in the II (41-60) and III (≥60) age group. Thus, the obtained results indicate differences in the course and clinical presentation of coronary heart disease, depending on the presence of comorbid pathology, which leads to a more severe disease course, a greater number of comorbidities with increasing age of patients.

Objective: The aim of the research was to determine the dependence of the blood flow velocity in the thyroid arteries in patients with Autoimmune Thyroiditis (AIT) on the presence of atherosclerotic carotid disease and the level of systemic blood pressure. Methods: The research involved 20 patients with AIT in euthyroid state, 30 patients AIT in euthyroid state with stable Coronary Heart Disease (CHD), 30 patients with stable CHD and 30 healthy individuals. Participants of the research were examined using ultrasound of carotid arteries and inferior thyroid arteries. Parameters of blood flow velocity were compared with the level of systemic blood pressure. Results: In AIT peak systolic velocity and resistance index in the inferior thyroid arteries were significantly higher than in healthy individuals and patients with CHD (p<0.05). In patients with CHD velocity parameters in carotid arteries were high, unlike in the healthy individuals and patients with AIT (p<0.05). In patients with AIT without CHD the atherosclerotic changes of carotid arteries were not found. Increased systemic blood pressure was noticed in all patients with CHD without significant differences between groups. Conclusion: The value of peak systolic velocity and resistance index of inferior thyroid arteries in autoimmune thyroiditis are noticed even with euthyroidism and do not depend on systemic blood pressure and atherosclerosis of carotid arteries. Increasing the thyroid arterial blood flow velocity parameters should be considered as sign of an active inflammatory period AIT, where advanced fibrosis is not present.

The cardiovascular pathology is a leading condition in the structure of clinical cases associated with overweight and obesity: more than two-thirds of cardiovascular mortality cases: annually, four million deaths worldwide are associated with a high body mass index (BMI). The awareness among the unorganized population aged from 20 to 82 years in the total number of 280 people was assessed. During the study it was found that overweight and obesity are quite common both among women (20.71 and 16.78%) and men (33.22% and 11.79%, respectively). Among the examined patients, an elevated blood pressure and various changes of the electrocardiogram were detected, of which left ventricular hypertrophy was observed in 57%, which is not only a compensatory reaction, but one of the most important independent factors for the cardiovascular risk. All respondents were offered to attend the Health Promotion School providing the educational program for prevention and correction of the main risk factors for obesity and heart diseases. The principle objective of this program was a change of lifestyle with a primary focus on patients with CVD, increased e physical activity and change of the quality of the diet rather than restricting its caloric value. The second survey was conducted in 6 months and the findings are as follows: BMI was corrected among overweight and obese female patients (14.22 and 13.57%), as well as among male patients (23.21% and 7.5%, respectively), thereby reducing the risk for cardiovascular diseases. The public awareness regarding the risk factors for cardiovascular diseases is considered to be low. Maintaining a healthy lifestyle, rational nutrition and educational program activities are the measures for management of overweight and obese patients resulting in reduction of the risk for cardiovascular diseases.

SYSTEMIC INFLAMMATION AND THE STATE OF CENTRAL HEMODYNAMICS IN PATIENTS WITH CORONARY HEART DISEASE

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