Unloading-dietary therapy (UDT) in integrated treatment and prevention of patients with arterial hypertension and obesity
The psychophysiological, functional, biochemical indices of the homeostasis of the patients with obesity and arterial hypertension under conditions of RDT had been studied using the clinical material (1533 patients). The RDT course, lasting 19-21 days, included either curative fasting, or a reduced diet (1000-1200 kcal/day) with unlimited access to water drinking, dosed physical activity, physiotherapeutic recreational procedures, teaching lectures. The weight loss of the individuals having obesity of II-III degree is mainly due to fat mass, and loss of muscle mass decreases as increasing degree of obesity. Along with the loss of body weight, a reliable and persistent decrease of blood pressure was noted due to a decrease of the heart intensity, a decrease in the parameters of peripheral vascular resistance, the most stated with people having arterial hypertension in combination with obesity. The improvement of the lipid spectrum indicators was noted, combined with a decrease in leptin and insulin resistance, an improvement in the protein-synthesizing function of the liver. As the weight was normalized, the concentration of leptin and insulin decreased and the physiological ratio of leptin-insulin was restored. The study of the parameters of acid-base equilibrium showed the presence of compensated metabolic acidosis, which does not require correction. The most marked changes in the intercellular sector were observed with patients who had a combination of arterial hypertension and obesity. Hypotensive and hypoglycemic drugs were canceled for most patients. These changes occurred against the background of life quality improving. The indicators of the heart and vessels pump function have been preserved after 3 years for people having healthy lifestyle.