bluuebunny/crossref_metadata_2025 huggingface dataset:
Recommendations on treatment strategies in hypertensivepatientswithmetabolic disorders
Authors: Zhernakova Yu V , Chazova I E
Published: February 2021

In 2013 experts of The Russian Medical Society on Arterial Hypertension (RMSAH) had prepared recommendations about management of patients with arterial hypertension (AH) and metabolic disorders (such as obesity, carbohydrate and lipid metabolism, hyperuricemia) and which chapters about diagnosis and correction were expanded, compared to the previous RMSAH recommendations. We also added a chapter about management of patients with AH and type 2 diabetes (T2D). Treatment and diagnosis algorithms of metabolic syndrome (MS) and T2D, discussed in these recommendations, will help us early identify and correct these disorders and will reduce cardiovascular events in patients with AH, even mortality one.
Chronic obstructive pulmonary disease combined with arterial hypertension: efficacy and safety ofthesustained-release indapamide (Arifon® retard)
Authors: Ovcharenko S I , Nersesyan Z N , Morozova T E
Published: February 2021

There is a problem of medicamental correction of arterial hypertension (AH) in patients with chronic obstructive lung disease (COLD), because number of drugs for the treatment of AH is limited in patients with bronchoobstractive diseases.The study shows that prolonged-release indapamide complex therapy is efficiency and safety (Arifon® retard) in patients with COLD associated with AH. The results demonstrate Arifon retard have positive effect on the AH: normalization of daily blood pressure (BP) profile and improvement of24-hour ambulatory blood pressure monitoring levels.At the same time it is shown that administration of Arifon retard does not affect the pulmonary ventilation rates (the results of the spirometry) and does not increase the lung hyperinflation (according to the results of Body plethysmography), and is not associated with hypokalaemia. The results of the study demonstrate that Arifon® retard can be used for safe correction of BP in patients with COLD associated with AH.
The impact of fixed combination of amlodipine and perindopril (drug Prestance)on the mechanisms of heat adaptation in patients with arterial hypertension
Authors: Ageev F T , Smirnova M D , Fofanova T V , Svirida O N , Mikhailov G D , Revich B A
Published: February 2021

Relevance. The impact of the drugs on adaptation to the heat wave of abnormal temperature has been one of the most important practical medicine questions, concerning heat waves, recent years. One of the points at issue is safety administration of calcium channel antagonists and ACE inhibitors during abnormal heat.Aim of the study is to assess the efficacy and safety of the fixed combination of perindopril arginine (drug Prestance, Servier Industries, Ltd.)/amlodipine in patients with arterial hypertension (AH) during the summer heat and the summer heat influence on the mechanisms of heat adaptation to abnormally high temperature.Material and methods: The study enrolled 165 patients with stages 1-2 AH: 69 patients with average risk and 91 patients with high/very high risk of cardiovascular complications. There were 69 men and 96 women in the study, living in Moscow city, in the Moscow and in the Ivanovo Regions. All patients were measuring office BP, undergoing biochemical analysis of blood, running questionnaire survey: visual analogue scale (VAS), questionnaire for the patients who were exposed to heat, the level of products reacting with the 2-thiobarbituric acid (malonyldialdehyde, MDA) and activity of superoxide dismutase (SOD) using standard test-kits and the pulse ware velocity (PWV) was measured in 30 patients. The first visit was in the first half of June 2013, the second visit - during the heat (July 2013) and the third one in September 2013.Results: In the course of the study SBP (systolic BP) and DBP (diastolic BP) were reduced (р
The effectiveness of zofenopril in patients with cardiovascular disease
Authors: Kukes V G , Anikin G S
Published: February 2021

Hyperactivity of the renin-angiotensin-aldosterone system plays an important role in the pathogenesis of any cardiovascular disease. Angiotensin - converting enzyme inhibitors are the main drugs among many medicines influencing the activity of the renin-angiotensin-aldosterone system, and these inhibitors have a wide range of beneficial effects. The presence of the sulfhydryl group in a molecule of angiotensin-converting enzyme inhibitor (zofenopril) determines the number of unique properties of this drug. Recent results have been showing the effectiveness of treatment in case of combined cardiovascular disease. This article presents the results of the studies showing the efficacy and safety of zofenopril.
Possibilities ARB II (sartans) in hypertensive patients
Authors: Morozova T E , Andrushchishina T B , Gontarenko S V
Published: February 2021

The article presents an overview of the literature on the choice of pharmacotherapy of arterial hypertension (AH). Among antihypertensive drugs occupy an important place ARBs II (BRA), a heterogeneous group of drugs whose representatives have significant intercompany differences. This article focuses on the properties and effects of olmesartan, that distinguish it from other ARBs. Along with a strong long-term antihypertensive effect of olmesartan has organoprotective (regression of LVH, nephroprotection etc.). Olmesartan clinical experience indicates a high efficiency and a good range of security among different categories of patients with hypertension.
Comparative evaluation of zofenopril. Are the characteristics of angiotensin I converting enzyme inhibitors important for the practice?
Authors: Kirichenko A A
Published: February 2021

The article provides an overview of the main comparative studies of antihypertensive efficacy and cardioprotective characteristics of zofenopril. We showed the information about the benefits of the drugs with higher tissue bioavailability preventing left ventricular hypertrophy and increasing its stiffness, because number of drugs possessing antiatherosclerotic and antiischaemic effects. The results of the studies, revealing the characteristics of action of these drugs class, will extend the capabilities of medical practitioners in the treatment of patients suffering from AH after acute myocardial infarction, associated with angina.
Methods of sympathetic activity evaluation in patients with systemic refractory hypertension
Authors: Grigin V A , Danilov N M , Sagaydak O V , Shelkova G V , Chazova I Ye
Published: February 2021

Despite the availability of modern medicines for treating the majority of cardiovascular diseases, the existence of such severe diseases as refractory arterial hypertension and pulmonary hypertension, has brought us to the development of the pathogenetic invasive method of such conditions treatment. Identification of potential responses at the stage of patients selection will help us to see in details the pathogenesis and development of this nosology, to determine the predictors of the efficacy of alternative methods of treatment sand to develop the protocol for these situations. From there, the article discusses various methods of activity evaluation of the sympathetic part of the vegetative nervous systemas the mainsector of pathogenesis of systemic hypertension development.
Phylogentic theory of pathology. Common phylogenetic features in the pathogenesis of essential arterial hyperntesion and insulin resistance syndrome
Authors: Titov V N
Published: February 2021

Our phylogenetic theory of pathology (algorrhythm of a disease development) is based on 1) a theory of biological functions and biological reactions in vivo; 2) regulation of biological functions, reactions, and metabolic processes at three phylogenetically different levels: а) autocrine (cell level); b) paracrine (in paracrine-regulated cell communities) and c) total organism level; 3) conceptions on formation of physiological and aphysiological processes («civilization» diseases) at various stages of phylogenesis. Universal pathogenesis of essential arterial hypertension and insulin resistance syndrome is based on functional discrepancy between phylogenetically early regulatory mechanisms at the level of paracrine cell communities and phylogenetically late regulation at the organism level. Pathogenic factors of this discrepancy are impaired biological functions of homeostasis, trophology, endoecology and adaptation. An increase in the content of unesterified fatty acids in the intercellular medium results from activation of lipolysis in paracrine community cells which cannot inhibit phylogenetically late insulin, but not in insulin-dependent adipocytes. The formation of pathogenesis of each metabolic pandemia occurs dynamically at different stages of phylogenesis.
The prevalence of carotid atherosclerosis in spontaneous populations in Tomsk
Authors: Zhernakova Yu V , Kaveshnikov V S , Serebriakova V N , Trubacheva I A , Oshepkova Ye V , Balahonova T V , Karpov R S , Chazova I Ye
Published: February 2021

Modern data on the prevalence of carotid atherosclerosis (CAS) in the general population are very limited both in Russia and abroad. In this study we investigated the prevalence of CAS using screening ultrasound examination in a random sample of spontaneous population aged 25-64 years in urbanized city of Western Siberia as part of a multicenter observational study ESSE-RF (epidemiology of cardiovascular diseases in different regions of the Russian Federation).The CAS prevalence was 36,4% in males and 24,4% in women in the examined population. We determined large variation of atherosclerotic plaques prevalence, depending on the age and gender. The CAS prevalence in creased more intense in males up to 50 years and in women 50 up to 59 years. Men were twice as likely to had been diagnosed CAS than women. The prevalence of CAS associated with amount of narrowing less than 25 and 50% or more in the examined population was 68,5%, and less than 1%, respectively. According to the results of the study we shouldpay great attention to the processes, leading to intensive development of CAS in the population aged 35-44 years, especially in men. The development of effective approaches to the control of modifiable risk factors for cardiovascular diseases in this age group could be a very appropriate measure for preventing the rapid development of the CAS in the population.
Dispersible Prestarium A tablets in the treatment of patients with arterial hypertension
Authors: Malchikova S V , Tarlovskaya Ye I
Published: February 2021

The research represents data on dispersing dosage form of Coversyl adherence and efficacy in real clinical practice.
Peculiarity of medical management of patients with arterial hypertension after liver transplantation
Authors: Kosmacheva Ye D , Babich A E
Published: February 2021

The article analyzes information of the prevalence, causes and mechanisms of development of hypertension in patients after liver transplantation. The authors integrate data from domestic and foreign literature about priorities of choice of antihypertensive drugs and possible changes in patterns of immunosuppressive drug therapy to reduce the risk of onset and progression of cardiovascular disease in patients who were underwent orthotopic liver transplantation.
Autoregulation hemodynamics in pregnancies complicated by hypertensive disorders
Authors: Makarov R A , Kinzhalova S V , Davydova N S
Published: February 2021

In the article the comparative analysis parametres of haemodynamics and features of autoregulation of haemodynamics in patients with uncomplicated pregnancy and pregnancy with hypertension is carried out.Complex investigation of central haemodynamics in 196 patients in the third trimester of pregnancy (65 - with physiologically proceeding pregnancy, 66 - with chronic arterial hypertensia, 65 patients with the pregnancy complicated by preeclampsia) by means of noninvasive bioimpedance technology with calculation of oscillatory activity and the spectral analysis of the three parametres of haemodynamics was carried.Authentic differences of parameters of central haemodynamics and the data of the spectral analysis between healthy pregnant women and pregnant women with hypertensive the disorders were received, the most expressed deviations are noted in preeclampsia.Considering compromised haemodynamics regulation in patients with preeclampsia the differentiated approach to therapy and choice of anesthesiological protection is required at operative delivery in this group of pregnant women.
Once again about the clinical efficacy and safety of sartans
Authors: Minina Ye S , Khadzhieva B R
Published: February 2021

Sartans are safety and effective class of anti-hypertensives nowadays. Sartans are the most effective inpatients suffering from arterial hypertension. Their efficiency is determined by the association of Angiotensin II type 1 receptor. Candesartan and azilsartan are themost powerful and approved angiotensin receptor blockers. Candesartan in comparison with azilsartan has wide proposed spectrum of clinical use. Azilsartan is indicated for the treatment of arterial hypertension. In terms of efficiency and safety we showed these sartans.
Ser49Gly polymorphic markers associations of ADRB1 gene and 4a/4b eNOS gene with hypertension and ischemic heart disease among the population of mountain shoria natives
Authors: Mulerova T A , Rubtsova E V , Kuz'mina A A , Tatarnikova N P , Maksimov V N , Voevoda M I , Ogarkov M Iu
Published: February 2021

The purpose: to investigate the frequencies of genes ADRB1 and eNOS genotypes and alleles among the population of Mountain Shoria natives (Shors) and their associations with hypertension and ischemic heart disease.Material and methods. Clinical and epidemiological study of the indigenous population of remote Mountain Shoria areas was conducted. 221 people were observed by the continuous method; the sampling included the adult population (18 years and older). Mean age for observed people was 51.07±1.46 years for men, 52.93±0.96 years for women ( p =0.286). Blood pressure measurement was performed by the method of the WHO/ISH (1999). Epidemiological criteria for ischemic heart disease and left ventricular hypertrophy were used on the basis of ECG coding changes by the Minnesota code. Anthropometric data, blood lipid profile, C-reactive protein, 4a/4b polymorphism of eNOS gene, A/G polymorphism of ADRB1 gene were studied.Results. The frequencies of A/G polymorphism genotypes ADRB1 gene in a population of Shors were in Hardy-Weinberg equilibrium (AA - 47.0%, AG - 41.4%, GG - 11.6%). Genotypes of gene eNOS were as follows: 4b/4b - 80.8%, 4a/4b - 18.7%, 4a/4a - 0.5%. The relative risk of hypertension developing at homozygous for the allele A compared with homozygous for the allele G and heterozygous is higher for 1.6 times (95% CI 1.18-2.09, p =0.003). Accordingly, the relative risk of disease for the carriers of the G allele less than for the carriers of allele A and heterozygotes [RR 95% CI 0.35 (0.12-0.99), p =0.035]. The level of systolic blood pressure is higher at homozygotes AA (137.8±2.5 mm Hg) in comparison with homozygous GG (127.4±4.0 mm Hg). AA genotype carriers had an increased risk of ischemic heart disease in comparison with genotypes AG and GG. The analysis of associations for 4a/4b polymorphism eNOS gene with phenotypic traits among the indigenous ethnic group didn’t reveal any statistically significant patterns.Conclusion. The connection between A/G polymorphism of ADRB1 gene and risk factors of ischemic heart disease (with a help of C-reactive protein, atherogenic index).A allele of ADRB1 gene among the Shor population is associated with the risk of hypertension and ischemic heart disease.
Clinical case: combination therapy with iloprost and sildenafil in the treatment of idiopathic pulmonary hypertension
Authors: Zavyrylina I N , Arkhipova O A , Saidova M A , Danylov N M , Martynyuk T V , Chazova I E
Published: February 2021

Idiopathic pulmonary arterial hypertension is a rare disease with unknown etiology, characterized by progressive increase in pulmonary vessel resistance, right heart failure. Combined pathogenetic therapy using leads to depression of disease progression, repeated hospitalization, improvement in disease prognosis in patients with III-IV functional class (WHO).The patient with diagnosis of idiopathic pulmonary arterial hypertension, verified by right heart catheterization method, functional class III (WHO) was treated by anticoagulants, diuretics. There were observed the negative dynamic with right heart chambers dilation, appearing of heart failure signs during the treatment with phosphodiesterase type 5-inhibitor sildenafil. After adding an inhaled form of prostanoids-iloprost to sildenafil therapy there was achieved the significant improvement of the functional and hemodynamic status. Reduction in dyspnoea level, improvement in physical activity tolerance and disease prognosis were reached.
Effects of amlodipine and atorvastatin on endothelial vasoactive mediators in patients with metabolic syndrome
Authors: Blinova N V , Masenko V P , Chazova I E
Published: February 2021

Aims: to study the effects of the amlodipine and atorvastatin on the blood levels of vasoactive mediators in patients with metabolic syndrome (MS). Design and methods. There were included 60 patients with MS, hypertension and dyslipidemia who were randomized into three treatment groups: monotherapy with amlodipine, atorvastatin monotherapy and a combination therapy with amlodipine and atorvastatin. Office blood pressure, 24-hour ambulatory blood pressure monitoring, measurements of the NO metabolite levels, endothelin-1, thromboxane B2 (TxB2) and 6-keto-prostaglandin F1α (6-keto-PGF1α) were performed at baseline and after 24 weeks of the therapy.Results. Amlodipine and atorvastatin in monotherapy or in a combination were associated with the significant improvement of certain studied parameters. Amlodipine treatment significantly decreased TxB2 and 6-keto-PGF1α levels. There was a significant reduction of TxB2, 6-keto-PGF1a levels and increase of NO metabolite in atorvastatin group. Treatment with combination of amlodipine and atorvastatin was characterized by significant decrease of TxB2 and endothelin-1 and increase of NO metabolite.Conclusion. Amlodipine and atorvastatin treatment showed positive effects on the levels of vasoactive mediators thereby leading to the improvementof endothelial function in patients with MS.
The results of the pharmacoepidemiological study PIFAGOR IV concerning arterial hypertension (AH patients survey)
Authors: Leonova M V , Belousov Yu B , Shteinberg L L , Alimova E E , Smirnova E P , Belousov D Yu
Published: February 2021

Group of researchers analytical group of PIFAGOR IV study The aim is to study the next step of pharmacoepidemiology of arterial hypertension (AH) in Russia to evaluate the structure and frequency of different classes of antihypertensive drugs (AHD) usage in clinical practice.Material and methods. The prospective pharmacoepidemiological multicenter study (PIFAGOR IV). We interrogated AH patients using special prepared questionnaires. The collection of questionnaires took place from February to July, 2013. The study included 2533 valid questionnaires from 52 cities and towns of Russia.Results. 80% of the patients regularly take AHD; 32.8% of patients receive monotherapy, 38.6% receive two AHD combinations, 28.4% - 3 or more AHD combinations. The average number of AHD was 2.02 per patient. The structure of AHD consisted of 5 recommended classes: ACE inhibitors (27.8%), -adrenergic receptor blocking agents (21.7%), diuretics (15.7%), calcium antagonists (11.3%) and angiotensin II receptor blockers (10.7%), fixed combination - 10.8%. Additional proportion of classes: central-acting agents - 2.3% and b-adrenoceptor blocking agents - 0.1%. Among the ACE inhibitors the main share had 3 drugs: enalapril (33.6%), perindopril (16%), and lisinopril (13%). In b-blockers class the main share had 2 drugs - bisoprolol (64.4%), and usual form of release and modified release dosage form of metoprolol (the total share 21,4%). Indapamide of standard and retard form took the first place in the structure of diuretics (the total share 75%). In calcium antagonists class the main share had amlodipine (55.8%). The main drug in ARBs II was losartan (55.4%). Central-acting agent class was consisted of moxonidine (66%), methyldopa (17%) and clonidine (5%). For about 76% of cases were presented by combinations containing diuretics and 24% - by combinations containing calcium antagonists among the fixed combinations. The proportion of original drugs in the structure of AHD was 38.3%. The average BP level in patients was 140.4/86.4 mm Hg and the blood pressure targets were determined in 50.2% of cases. A high degree of compliance according to the Morisky-Green test indicated in 32%, low compliance - in 49% of cases.Conclusions. We noted the reduction of ACE inhibitors proportion and increase of ARBs II proportion, increase of fixed combinations in the structure of AHD. However, we noticed the decrease of the treatment efficacy in patients with AH using average BP level and achievement of the target BP, as well as the average number of AHD.
Patients with arterial hypertension associated with metabolic disorders: characteristics and therapeutic approach
Authors: Zhernakova Yu V , Sharipova G H , Chazova I E
Published: February 2021

Arterial hypertension (AH) is associated with metabolic disorders in approximately 80% of cases. There is a pandemic of so-called new risk factors, such as insulin resistance and association with systemic type of hyperinsulinemia, abdominal obesity, hyperinsulinemia and a special type of dislipidemy, nowadays. Patients with AH associated with such metabolic disorders are at a higher risk of developing cardiovascular disease and diabetes. However, it is very difficult to achieve the target level of blood pressure in this category of patients. Usually, these patients should be treated using combination therapy at the beginning of the treatment. Drugs, which possess good antihypertensive effect, as well as an additional positive influence on metabolic parameters, for instance I2-imidazoline receptor agonists, can be used as the drugs of choice in combination with ACE inhibitorsor angiotensin II receptor blockersin this category of patients.
The association of arterial hypertension and ischemic heart disease is the main problem in modern cardiology practice
Authors: Ostroumova O D , Dudaev V A , Fomina V M
Published: February 2021

This article deals with the epidemiological datashowing higher frequency of arterial hypertension (AH) in patients with ischemic heart disease (IHD). We discussed the basic characteristics of modern domestic and foreign recommendations for treating patients with combination of AH and IHD. We showed the target of blood pressure (BP) in this category of patients. This article deals with the priority groups of antihypertensive drugs, which have the advantages in the combination usage in patients with association of these diseases. We fixed special attention to the problem of BP variability (BPV) as a new risk factor for the development of coronary complications in patients with AH. We showed the possibility of fixed combination of perindopril and amlodipine in reducing interand intervisit BPV in patients with AH and IHD in actual clinical practice.
Central and humoral mechanisms for arterial hypertension in women
Authors: Podzolkov V I , Bragina A E , Rodionova J N , Koloda J A
Published: February 2021

The article discusses various mechanisms of arterial hypertension (AH) development in postmenopausal women. It includes literature data on the sexual hormones, namely estrogen and progesterone deficit and androgen overproduction, influence on the blood pressure level and metabolic disorder. Special focus is on the role of renin-angiotensin-aldosterone system in AH pathogenesis. Separate paragraph is focused on the role autonomous nervous system dysfunction and disorders of biogenic amines metabolism in the vascular and autonomic disorders in climacteric syndrome, as well as the contribution of the humoral shifts typical for central obesity, such as hyperinsulinemia, and hyperleptinemia.
Treatment of hypertension in overweight patients
Authors: Kukes V G , Anikin G S , Andreevskaya E M , Ashurkova E A
Published: February 2021

The aim of the treatment of hypertension in patients with overweight is not only normalization of blood pressure, but also improvement of endothelial function, reduction of insulin resistance and lipid metabolism. Some of the drugs with a broad therapeutic spectrum and huge evidential base, - I1-imidazoline-receptor agonists can be applied in both monotherapy and as a part of the combined therapy in overweight patients.
Treatment with perindopril in patients with arterial hypertension: improving compliance
Authors: Anikin G S , Minina E S , Andreevskaya E M
Published: February 2021

The problem of the compliance is relevant in the treatment of patients with arterial hypertension. The review presents the data to identify mechanisms for improving the compliance in the context of one of the most studied drugs, such as - perindopril. We have indicated the aspects of perindopril monotherapy, as well as in combination with indapamide and amlodipine. We have showed the advantages of fixed combinations. The individual aspect of the easy medicine administration isdispersion form of the drug. This article shows the advantages of usage PrestariumR ORO - innovative form of perindopril, mouth dissolving tablets.
From the choice of antihypertensive drug to the choice of fixed combinations of antihypertensive drugs: a paradigm shift
Authors: Ostroumova O D , Bondarets O V , Kopchenov I I , Guseva T F
Published: February 2021

The article considers modern approaches to treatment of arterial hypertension. Emphasizes the need for combination antihypertensive therapy, mainly fixed combinations of antihypertensive drugs, patients with high and very high risk already at the start of treatment. Discusses the advantages of combinations of blockers of receptors of angiotensin II to diuretics and calcium antagonists, as well as clinical situations in which these combinations are a priority. Considered the evidence base, pharmacokinetics and clinical benefit of the representative of a class of blockers of receptors for angiotensin II and losartan.
Pathogenetic treatment of chronic heart failure: the role of torasemide
Authors: Perepech N B
Published: February 2021

The article discusses the torasemide pharmacokinetic characteristics which are favourably different from furosemide characteristics. We paid attention to the fact that torasemide had anti-aldosteronic and antifibrotic effects; all these characteristics were alien to other diuretics nature. The results of clinical studies showed torasemide ability to prevent the development and reverse myocardial fibrosis. Taking into account modern representations concerning the pathogenesis of chronic heart failure, in particular the role of diastolic dysfunction in developing haemodynamic compromise, we substantiated torasemide application as a part of complex pharmacotherapy of chronic heart failure in patients with elevated left ventricular filling pressure before the appearance of clinical manifestations of stagnation.
The role of b-blockers in treatment of hypertension, according to Russian and European experts
Authors: Ostroumova O D , Fomina V M , Shchukina G N , Smoliarchuk E A
Published: February 2021

The article focuses on the use of b-blockers for the treatment of arterial hypertension (AH). Given the situation of modern Russian and European recommendations about the place of b-blockers in the treatment of AH, including their benefits with a combination of hypertension with coronary heart disease, chronic heart failure, atrial fibrillation. Analyzed the efficacy and safety of b-blockers in diabetes mellitus, metabolic syndrome, dyslipidemia, peripheral artery, chronic obstructive pulmonary disease, sexual dysfunction, in individuals of different age and gender. It is emphasized that the selection of b-blockers inside of a class is determined by its selectivity, the study in clinical studies, pharmacokinetic characteristics. Data about efficiency and safety of application of metoprolol succinate.
Myocardial ischemia in patients with pulmonary arterial hypertension
Authors: Arkhipova O A , Martyniuk T V , Valeeva E G , Ryabykina G V , Samoylenko L E , Sergienko V B , Chazova I E
Published: February 2021

The precordial region. Pain in the chest in these patients is associated with relative coronary insufficiency due to low cardiac output, a relatively weak development of coronary collaterals on the background of hypertrophy of the wall of the right ventricle or reflex constriction of the coronary arteries due to distension of the pulmonary artery (viscero-visceral reflex), lowest saturation of blood oxygen at an advanced stage, as well as compression of the left main coronary artery dilutionin the pulmonary artery trunk. Many of them in electrocardiography revealed changes similar to ischemic. The purpose of this study was to identify signs of myocardial ischemia in patients with pulmonary arterial hypertension and evaluate the relationship of pain with the presence of ischemic changes according to 12 channel Holter ECG monitoring, and synchronized single photon emission computed tomography myocardial alone and in combination with load tests.
Comparison of vectorcardiographic parameters with structural-functional state of the right ventricle in patients with pulmonary hypertension
Authors: Blinova E V , Sakhnova T A , Saidova M A , Loskutova A S , Ryabykina G V , Arkhipova O A , Martynyuk T V , Trunov V G , Aidu E A , Chazova I E
Published: February 2021

Changes of the vectrocardiographic ventricular gradient (VG) in patients with pulmonary arterial hypertension (PAH) are indicative of right ventricular (RV) overload and may be used to assess its severity. The study aim was to evaluate interrelations between vectrocardiographic VG, spatial QRS-T angle and echocardiographic parameters of structural-functional state of the RV.The following parameters were assessed in 30 PAH patients: RV dimensions; tricuspid annular plane systolic excursion (TAPSE); RV fractional area change (FAC); RV peak systolic annular velocity (TDI-S’), and longitudinal strain (LS). VG and spatial QRS-T angle were calculated using the orthogonal leads derived from standard echocardiography.Spatial component VG-Y had moderate negative correlation with LS (r=-0.62; p
Workplace hypertension": focus on emotional and personality traits in patients
Authors: Ostroumova O D , Pervichko E I , Zinchenko Yu P
Published: February 2021

This article discusses the literature data on the prevalence, diagnosis and mechanisms of development of “workplace hypertension”. The paper contains the results of our own studies indicating that patients with “workplace hypertension” are suffering from different emotional and personality traits, such as high emotionality, suppression of emotional expression, and use of inefficient emotion regulation strategies, significant perfectionism associated with socially prescribed perfectionism.
Main questions of β-blockers application in clinical practice: do they all the same?
Authors: Nebieridze D V
Published: February 2021

The present review shows the modern view on β-blockers in different clinical situations. Class β-blockers is a heterogeneous group in terms of clinical use. Several variants of β-blockers, especially non-selective, have negative effects and cannot be used in several clinical situations (metabolic disorders, chronic obstructive pulmonary disease, peripheral arteriosclerosis). Modern superselective β-blockers, including Betaloc ZOK, does not possess the mentioned adverse effects and can be widely used in clinical practice, even in case of metabolic syndrome, type 2 diabetes and chronic obstructive pulmonary disease. Another problem associated with β-blockers is the rare application of the drug and the underdosing of the drug. In this regard, it is very necessary for the practitioner not to be afraid and to start prescribing them in the recommended therapeutic doses according to the instructions for the medical applications for drugs in different clinical situations.
Strategy of medical treatment of pulmonary arterial hypertension in the current international recommendations
Authors: Martyniuk T V , Chazova I E
Published: February 2021

Significant progress in the treatment of pulmonary arterial hypertension (PAH), in recent years, is associated with the introduction into clinical practice of a number of drugs pathogenetic action, can cause vasodilation and reverse remodeling of pulmonary vessels. Recently PAH-specific therapy was replenished with new drugs. This review is created as a result of the analysis of modern American recommendations CHEST and recommendations of the European society of cardiology and the European respiratory society (ESC/ERS) in order to provide all professionals involved in the maintenance of the PAH, data on the main approaches to the pharmacotherapy and the optimal choice of pharmacological treatment methods.
Features of cutaneous microcirculatory blood flow in patients with pulmonary hypertension of different etiology
Authors: Dolgova E V , Fedorovich A A , Martynyuk T V , Rogoza A N , Chazova I E
Published: February 2021

Aim: to evaluate features of the functional state of microvascular bed of the skin in patients with pulmonary arterial hypertension associated to congenital cardiac disease (PAH-CCD) and chronic thromboembolic pulmonary hypertension (CTEPH). Methods. In study included 25 patients (41.6±15.8) with PAH-CCD, 25 patients (48.8±14.2) with CTEPH and 25 healthy volunteers (39.3±10.1 years). All the patients underwent a six-minute walking test (6-MWT), transthoracic echocardiography, thorax organs radiography, right heart catheterization (RHC) and Laser Doppler flowmetry (LDF) with amplitude and frequency wavelet analysis of blood flow oscillations and evaluation of constrictory and dilatatoryskin resistive microvesselsfunctions. Results. In the PAH-CCD in relation to the CTEPH groupaccording to the RHC were noted significantly higher values of systolic pressure in pulmonary artery (93.2 and 77.8 mm Hg respectively) and venous mixted blood saturation(63 and 57% Hg respectively). On this background 6- MWT distance was 356 and 325 m, the Borg dyspnea scale index was on average 3.12 and 3.76 respectively. According to the LDF pulseoximetry PAH-CCD and CTEPH patients had 90.1 and 94.7% respectively. According to the LDF with amplitude and frequency wavelet analysis the PAH-CCD patients had sig-nificantly higher values of the amplitude of myogenic, respiratory and pulse sectionof blood flow modulation, and also increased constrictory activity smooth muscle cells of skin precapillary arterioles in response to the stretching at venous occlusion and decreased dilatatory reserve at post-occlusi-ve reactive hyperemia. According to the LDF the CTEPH patients had elongationof time development of microvessel constriction in response to acti-vation of sympathetic nervous systemin respiratory and cold tests. Conclusion. According to the LDF functional state of skin microvessels in systemic circulation of the CTEPH patients was comparable with control groupexcept for elongation of time development of microvessel reactions for sympathetic vasoconstrictor stimulations. The PAH-CCD patients demonstrated basal tonus decreasing of smooth muscle cells of skin precapillary arterioles in systemic circulation, which can be regarded as a manifestation of autoregulatory response to systemic hypoxia.
Radiofrequency renal arteries denervation: effectively and safely
Authors: Grigin V A , Danilov N M , Matchin Yu G , Chazova I E
Published: February 2021

Objective. To determine the possibility of radio frequency denervation of the renal arteries (RDN) in the treatment of patients with refractory essential hypertension (GRA). Materials and methods. The study included 57 patients with a diagnosis of the guide RAG. According to the results of surveys conducted by RDA was performed of 25 patients diagnosed with essential RAG. Within 12 months after the procedure was carried out monitoring of clinical blood pressure (BP), BP monitoring (ABPM), and laboratory evaluation of renal function and renal artery ultrasound. Statistical analysis was performed using Statistica 6.1 program, significant differences were recognized when p
"Grey zone" of vasoreactivity during acute vasodilator testing in patients with pulmonary hypertension
Authors: Sagaydak O V , Danilov N M , Matchin Yu G , Martynyuk T V , Chazova I E
Published: February 2021

Aim - to analyze functional status and hemodynamic changes in patients who demonstrate vasoreactivity but doesn’t reach the criteria of "positive respond" ("grey zone") and to compare this data with "responders" and "true non-responders". Material and methods. We enrolled 159 patients with pulmonary hypertension. Right heart catheterization with acute vasodilator testing was performed in all cases. Depending on hemodynamic respond during acute vasoreactivity testing patients were divided in to three groups: "responders", "true non-responders" and patients in the "grey zone". The following parameters were analyzed in all included patients: basic clinical parameters, hemodynamic changes, right ventricle size, right atrium area, 6-minute walking test distance and time to clinical worsening. Results. In our study it was shown that patients of "grey zone" had several clinical and hemodynamic parameters that differ significantly from patients "responders" and "true non-responders". Patients in the "grey zone" also have the longest time to clinical worsening.
The application of ivabradine in the management of ischaemic heart disease
Authors: Gurevich M A , Kuzmenko N A
Published: February 2021

Ischemic heart disease is not only serious disorder with special clinical characteristics and generally requiring multidisciplinary approach, but also a social and economic problem now. Heart rate control is one of the main therapeutic principles that should be applied in patients with ischemic heart disease. In practice there are always cases when β-blockers for reducing heart rate should not be used because of contraindications in patients (for example, disorders of carbohydrate and lipid metabolism). Ivabradine can be an alternative in this situation due to selective and specific inhibition of the If-channels current across the cardiac pacemaker, characterized by negative chronotropism without negative inotropic effect and without affecting atrioventricular conduction and blood pressure. Ivabradine therapy is generally well tolerated and increases adherence commitment of patients to treatment. Raenom® (Gedeon Richter, Hungary) is generic ivabradine of good-quality.
The effect of combined antihypertensive therapy on arterial wall rigidity in male patients with hypertension, obesity and obstructive sleep apnea
Authors: Elfimova E M , Zairova A R , Andrievskaya M V , Bogieva R M , Rogoza A N , Litvin A Yu
Published: February 2021

Goal: to study the effectiveness of combination antihypertensive therapy (AHT) and its influence on the indices characterizing the arterial stiffness of various types in patients with arterial hypertension (AH) in combination with obesity and severe obstructive sleep apnea (OSA). Material and methods. The study included 27 male patients with hypertension [143.0 (142.0; 150.0)/91.0 (85.3; 94.8) mm Hg. century], obesity [body mass index of 33.8 (32.0; 37.2) kg/m2] and OSA was severe [the index of apnea/hypopnea - AHI - 46.8 (33.3; 63.4) events per hour] who underwent AHT titration to achieve target values of blood pressure (BP), a fixed combination of the calcium antagonist amlodipine (10 mg) and the angiotensin-converting enzyme inhibitor perindopril (5-10 mg). At baseline and after 4-6 weeks when reaching target blood pressure was assessed pulse wave velocity (PWV) using different instrumental techniques. Carotid-femoral PWV (CFSP) was determined by applanation tonometry (SphygmoСor AtCor, Australia), aortic PWV - ultrasonic technique in the descending aorta (thoracic spine), the ankle-brachial PWV - using volumetric sphygmography (VaseraVS-1000 Fukuda Dens, Japan). Results. The target pressure (according to clinical blood pressure, daily monitoring blood pressure) on the background of amlodipine 10 mg and perindopril 5 mg was 58% patients and 42% of patients reached the target level of blood pressure against the background amlodipine 10 mg and perindopril 10 mg. On a background of 4-6 weeks of admission AHT 33.8% increase in the number of patients with a normal circadian profile of blood pressure - «dipper». Upon reaching the target blood pressure revealed a significant decrease CFSP, ankle-brachial PWV and aortic PWV 11.4, 11.0 and 15.4%, respectively. Conclusion. A fixed combination of perindopril arginine and amlodipine in patients with arterial hypertension of the 1st degree in the presence of obesity and OSA allows achieving a good level of BP control, to improve the performance of the daily profile and to improve the elastic properties of large arteries, which has a beneficial protective effect in these patients.
Prolonged release verapamil: application in clinical practice
Authors: Gaponova N I , Abdrakhmanov V R
Published: February 2021

The review shows the results of the use of prolonged release verapamil (Isoptin® SR) in clinical practice. Numerous randomized clinical studies confirm the high efficiency and safety of Isoptin® SR in patients with arterial hypertension, as well as in patients with arterial hypertension in combination with ischaemic heart disease, chronic obstructive pulmonary diseasesand disorders of carbohydrate and lipid metabolism. The advantage of Isoptin® SR (verapamil) application in case of supraventricular arrhythmias has been proven.
The control of blood pressure level as the prevention of cognitive impairment
Authors: Melnik M V , Afonicheva I I , Kazyulin A A
Published: February 2021

Today the prevalence of cognitive impairment is a large scale. At the end of the pathological process partial or complete, social, professional and common maladjustment and disability comes. One of the main factors of progression of cognitive impairment is a decrease in adherence to the therapy, forming a vicious circle of the underlying disease and its complications. In the article we examine the prevalence, pathogenesis and classification of cognitive impairment of patients with arterial hypertension, memory impairment, analyze the relationship of high blood pressure numbers. The use of modern antihypertensive drugs, with adequate control of blood pressure reduces the risk of development and progression of cognitive impairment. To this end, successfully it can be used calcium channel blocker lercanidipine third generation, which has high anti-hypertensive activity, cerebroprotective function, causing regression of cognitive disorders, enhancing the quality of life of patients. Nowadays there is a small number of studies investigating the effect of calcium channel blockers on cognitive function, that led to the study of this issue.
The effect of antihypertensive therapy and CPAP therapy on inflammatory and endothelial dysfunction markers levels in patients with severe obstructive sleep apnea syndrome in association with arterial hypertension
Authors: Elfimova E M , Rvacheva A V , Tripoten M I , Pogorelova O V , Balakhonova T V , Zykov K A , Litvin A Yu
Published: February 2021

Objective. To evaluate the effect of antihypertensive therapy (AHT) and CPAP therapy on inflammatory and endothelial dysfunction markers levels in patients with severe obstructive sleep apnea (OSA) syndrome in association with arterial hypertension (AH). Materials and methods. The study included 43 male patients with severe OSA syndrome (Apnea-Hypopnea Index 52.4 [46.1; 58.6]) and AH (systolic blood pressure 144.0 [142.0; 156.0] mm Hg, diastolic blood pressure 90.9 [88.3; 93.5] mm Hg). Treatment with angiotensin-converting enzyme inhibitors, calcium antagonists, and thiazide-like diuretics was performed till target BP level measured with Korotkoff method was achieved. The patients who had reached target BP level (BP≤140/90 mm Hg) were randomized into two groups: group 1 included 23 patients who continued taking the AHT, group 2 included 22 patients who continued taking the AHT to which CPAP therapy was added. Peripheral blood lymphocyte immunophenotyping, cytokine panel test (IL-1β, IL-6, tumor necrosis factor a, IL-2Ra, sCD40L), adhesion molecule analysis (ICAM-1, VCAM-1), thromboxane B2, 6-keto-prostaglandin F1 alpha (6-keto-PGF1a), and endothelin-1 levels in blood serum were evaluated at admission, after target BP level achievement (2nd visit) and after 3 months of AHT or AHT+CPAP therapy (3rd visit). Flow-mediated dilation of brachial artery was assessed using reactive hyperemia test by D.Celermajer. Results. Against the background of combined AHT the target BP level was achieved by 95% of patients. After target BP level achievement a significant decrease of IL-1β -0.16 [-0.5; 0], p=0.000 level and number of CD50+ cells (lymphocytes with inter-cellular adhesion molecule ICAM-3) from 2158.5 [1884.7; 2432.3] to 1949.6 [1740.9; 2158.3], p=0.050 were observed in patients with severe OSA associated with AH. There were no significant changes in vascular endothelial function observed in patients taking only AHT. Significant decrease of fibrinogen (-0.3 [-0.4; -0.1], p=0.002) and homocystein (-2.03 [-3.8; -0.2], p=0.03) levels was observed in patients taking both AHT and CPAP therapy. Conclusion. The combination of AHT and CPAP therapy in patients with severe OSA and AH not only allows reaching the target BP level but also leads to inflammatory and endothelial dysfunction markers levels decrease.
The effect of combined therapy on the properties of the vessel wall in patients at high risk of cardiovascular complications
Authors: Blankova Z N , Aslanyan N S
Published: February 2021

Introduction. The evaluation of therapy effectiveness in patients at high risk of cardiovascular complications includes the evaluation of target organs condition. A complex approach means follow-up control of laboratory and instrumental data. Materials and methods. The study included 113 patients with hypertension and nonstenotic atherosclerosis of brachiocephalic arteries. All the patients received antihypertensive therapy and some received hypolipidemic drugs. Cholesterol and low density lipoproteins (LDL) levels, brachial and central blood pressure (BP), brachial-ankle and carotid-femoral pulse wave velocity (baPWV and cfPWV, respectively), augmentation index (AI) of fibrosis markers (C-terminal telopeptide from collagen I (CITP) and C-terminal terminal propeptide of pro-collagen I (PINP) were assessed at baseline, after 6 months and 12 months of treatment with fixed combination of amlodipine, lisinopril and rosuvastatin. Results. The conducted therapy was followed by lowering the LDL levels from 3.9 (3.1; 4.6) to 2 (1.8; 2.3) mmol/L (p
Clinical Manual for Diagnosis, Prevention and Treatment of Cardiovascular Complications of Cancer Therapy. Parts II-V
Authors: Chazova I Ye , Tyulyandin S A , Vitsenia M V , Poltavskaya M G , Gilyarov M Yu , Martynyuk T V , Ovchinnikov A G , Panchenko E P , Fedotkina Yu A , Stenina M B , Trophimova O P , Ageev F T
Published: February 2021

Advances in treatment have led to improved survival of patients with cancer but have also resulted in untoward side effects associated with treatment. Cardiovascular diseases are one of the most frequent of these side effects. Myocardial dysfunction and heart failure, myocardial ischaemia, arrhythmias, arterial hypertension, thromboembolic disease and other cardiovascular complications can interfere with the efficacy of treatment, decrease quality of life, or impact the actual survival of the patient with cancer. This manual discusses concepts for timely diagnosis, intervention, and surveillance of patients treated with cardiotoxic cancer therapies. In this second part оf manual we discuss the diagnostic, prevention and treatment aspects of cancer therapy-related coronary artery disease, arterial hypertension, arrhythmias and pulmonary hypertension.