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Timely correction of vegetative homeostasis disorders is the prevention of hypertension development among the children

SOVREMENNAYA PEDIATRIYA.2019.1(97):102-110; doi 10.15574/SP.2019.97.102

Kvashnina L. V., Ignatova T. B., Maydan I. S.
SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the National Academy of Medical Sciences of Ukraine», Kyiv

The article deals with the peculiarities of vegetative homeostasis, endothelial function, lipid metabolism among children with the risk of developing primary arterial hypertension. 19.5% children with «normally high» blood pressure have been examined according to daily monitoring data. In this group of children contraventions of the vegetative homeostasis in the form of initial vagotonia were noted among 80.6% of children, and approximately the same number of children had disorders of autonomic reactivity in the form of hypersympathicotonia among 46.5% of children and asympathicotonia among 38.9% of children. Among the examined children with daily monitoring of arterial pressure, the increase to «normally high» numbers was noted, the increased blood pressure variability is characteristic. The systolic blood pressure load among 25.0% of children and diastolic blood pressure among 10.0% of children characterize the risk of target organ defeats. For the examined children various types of endothelial dysfunction were identified, while the paradoxical type prevailed (42.6% of children), during which the increase of endothelin-1 level in the blood was noted, which has an angiospasmic effect. Also, among the examined children, there was a disturbance in the system of lipid peroxidation towards its activation; contraventions of lipid metabolism in the form of various dyslipidemias were found among 87.5% of children. A scheme for the correction of the identified contraventions with the usage of «Kratal for children», «Smart omega for children» and «Quertin», which are recommended for 8 weeks, is proposed. The usage of these drugs has significantly reduced clinical expressions, normalized blood pressure (88.5% of children), autonomic homeostasis among 77.0% of children, endothelial function among 74.1% of children and lipid metabolism among 85.4% of children. All used drugs are well perceived, have no toxic effect and do not cause an allergic reaction, are quite effective and safe in treating children with expressions of autonomic dysfunction syndrome and indicators of «normally high» blood pressure.

Key words. Children, «normally high» blood pressure, endothelial function, lipid metabolism.

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Article received: Nov 07, 2018. Accepted for publication: Jan 24, 2019.