PECULIARITIES OF 24-HOUR BLOOD PRESSURE MONITORING IN HYPERTENSIVE PATIENTS DEPENDING ON THE FUNCTIONAL STATE OF THE THYROID GLAND.

The aim of the work was to study the influence of the functional state of the thyroid gland on the peculiarities of the clinical course of arterial hypertension (AH) and indicators of Ambulatory blood pressure monitoring (ABPM). The study included 130 patients with AH, of whom: Group 1-50 patients with AH in combination with hypothyroidism (mean age - 56,34±10,23 years, mean duration of AH - 8,76±6,81 years, duration of hormone replacement therapy for hypothyroidism - 9,38±5,70 years); Group 2-50 patients with AH in combination with thyrotoxicosis (mean age 52,62±12,70 years, mean duration of AH -6,54±4,02 years, duration of thyrotoxicosis - 3,90±2,56 years). The control group consisted of 30 patients with AH, who were statistically comparable in age - 56,23±7,64 years, duration of AH -8,87±4,45 years, in whom thyroid dysfuctation was excluded during the examination. Patients underwent ABPM after achievement of the target systolic blood pressure (SAR) level ˂ 140 mm Hg against the background of the prescribed antihypertensive therapy. Patients with AH, both in the presence of hypothyroidism and in the presence of thyrotoxicosis have worse control of blood pressure than patients with AH without thyroid dysfunction, and reliably more often have masked uncontrolled hypertension (p1-2=0.232; p1-k=0.003; p2-k=0.036). In patients with AH and hypothyroidism when reaching the office ADS ˂ 140 mm Hg against the background of the prescribed antihypertensive therapy, the level of thyroid hormone > 5.96 мМЕ∕ l is an independent factor, which is associated with the lack of adequate control of ADS at night (according to the results of ROC - analysis). In patients with AH and thyrotoxicosis when reaching the office ADS ˂140 mm Hg against the background of prescribed antihypertensive therapy, the level of thyrotrophic hormone ≤0.1 мМЕ∕l is an independent factor, which is associated with the lack of adequate control of ADS at night (according to the results of ROC - analysis).