bluuebunny/crossref_metadata_2025 huggingface dataset:
The phenomenon of long-term commitment (16 years) patients with physical rehabilitation after acute myocardial infarction
Authors: Bubnova M. G , Krasnitskii V. B , Aronov D. M , Novikova N. K , Kadushina E. B , Matveeva I. F
Published: February 2021

Goal. Description of the influence of systematic phisical training (PT) on some indicators of physical performance (Fed) and the assessment of daily locomotor activity and psychological status of patients after myocardial infarction and were followed for 16 years. Material and methods. We observed 11 patients (9 men and 2 women) who after acute myocardial infarction (AMI) have participated in a one-year rehabilitation program, the basis of which amounted to the controlled PT of medium intensity (50-60%). Subsequently, patients continued PT program in hospital and in the home environment (observation of patients was 16 years). Programs of systematic PT were performed in a hospital, carried out with a small break in 2014-2015. Patients are constantly trained (ie the period of continuous PT amounted to 2 years), while a program of home exercises, patients try to perform consistently. They all underwent clinical examination, had a load test performed on a cycle ergometer protocol submaximal loading, questionnaires were evaluated by physical activity, level of subjective control, anxiety and depression and adherence to therapy estimated. Results. Blood pressure (BP) in patients were stable: in 2014 (prior to the beginning of organized PT) systolic blood pressure (SBP) was 127.9±15.2 mm Hg and diastolic blood pressure (DBP) - 74±6.3 mm Hg. In 2 years (2015) after the resumption of organized PT SBP decreased slightly to 121.2±7.0 mm Hg (p0.05), ie, 16 years. In 2015, when compared with the 1999 peak of PE decreased SBP by 4.6% (p
Current state and problems of cardio rehabilitation in Russia
Authors: Aronov D. M , Kozlova L. V , Bubnova M. G
Published: February 2021

The article is devoted to the problem of organizing cardio rehabilitation in the Russian Federation. The results of clinical studies and meta-analyzes assessing the clinical effectiveness of cardiac rehabilitation are presented. The advantages of cardiac rehabilitation, both clinical and economic, are indicated. The problems of slow pace of organization of the cardio rehabilitation infrastructure in the country are analyzed.
Non-invasive stimulation of angiogenesis with shock-wave therapy in patients with coronary artery disease (literature review). Part 2
Authors: Matskeplishvili S. T , Borbodoeva B. M
Published: February 2021

The article presents a review of published data regarding the most important problem in cardiology - treatment of patients with coronary artery disease and left ventricular dysfunction and improvement of quality of life in this group. The review covers the contemporary management of coronary artery disease, new approaches to the treatment of coronary artery disease in patients without possibility of myocardial revascularization or having undergone revascularization. The safety and effectiveness of shock-wave therapy in this group of patients is presented.
Acute kidney injury worsens outcomes in acute decompensation of chronic heart failure
Authors: Davydov V. V , Arekhina E. L , Tarasova M. S
Published: February 2021

Acute kidney injury was 33.6% of patients had acute decompensation of chronic heart failure. This complication has increased the number of cardiovascular diseases, relapses of chronic heart failure decompensation and mortality during the next 12 months.
The role of non-alcoholic fatty liver disease in the development of cardiovascular diseases
Authors: Eganyan R. A
Published: February 2021

The review describes the pathogenetic mechanisms of the relationship between cardiovascular disease and non-alcoholic fatty liver disease (NAFLD), which is the rationale for selecting therapeutic targets for intervention. The role of insulin resistance, oxidative stress, inflammation, dyslipidemia, intestinal microflora, heredity in the pathological relationship between NAFLD and cardiometabolic disorders are discussed. Present-day data of domestic and foreign scientists on prevalence, etiology, pathogenesis, clinical picture and treatment of this comorbid state are presented. Information is given on the development of subclinical and clinical atherosclerosis, as well as the concept of the hepatocardial continuum. In the treatment of NAFLD, the main role is given to the elimination or correction of etiopathogenetic factors of the development of the disease, excessive body weight, obesity, insulin resistance, hyperglycemia, hyperlipidemia. Particular attention is paid to the issues of dietetic complex intervention and the influence of various nutrition components on the state of the cardiovascular system and the liver.
The abilities of losartan in angioprotection in hypertensive patients with hyperuricemia
Authors: Nedogoda S V , Ledyaeva A A , Chumachok E V , Tsoma V V , Salasyuk A S
Published: February 2021

Aim: to evaluate the ability of the angiotensin II receptor blocker losartan (Lorista, KPKA) to reduce the level of uric acid and to correct the parameters of vascular wall elasticity in patients with arterial hypertension, hyperuricemia, and gout. Subjects and methods. An open-label, randomized, controlled, parallel group comparative (losartan versus conventional therapy with other antihypertensive drugs for 24 weeks) trial enrolled 40 patients with arterial hypertension, hyperuricemia, and gout. Results. No significant differences were found between the groups of losartan (Lorista) and conventional therapy with other antihypertensive drugs groups in their antihypertensive activity. At the same time the losartan group showed a considerably more decrease in uric acid levels than did the conventional group (34,7% versus 7,8% in the group of therapy with other antihypertensive drugs (p
The place of Indapamide retard in the treatment of patients with left ventricular dysfunction and preserved systolic function in the presence of arterial hypertension
Authors: Tereshchenko S N , Zhirov I V
Published: February 2021

The issue of blood pressure levels is practically very important in patients with chronic heart failure (CHF). As is known, combination therapy for the latter implies the use of several groups of hemodynamically relevant agents; diuretics are an important component of CHF therapy. However, diuretics are the most unstudied medications in the treatment of patients with CHF in the context of evidence-based medicine. On the one hand, their efficacy and necessity for the treatment of patients with cardiac decompensation are beyond question and, on the other, even if you want, placebo-controlled trials using diuretics look difficult to perform.
Additional possibilities of antihypertensive therapy for metabolic syndrome
Authors: Kislyak O A , Pokhilchenko M V
Published: February 2021

Metabolic syndrome (MS) is a clinical and laboratory symptom complex that encompasses abdominal obesity, carbohydrate and fat metabolic disturbances, arterial hypertension (AH), and target organ involvement. The drugs of first choice in the management of patients with AH and MS are renin-angiotensin-aldosterone system (RAAS) inhibitors, angiotensin receptor blockers (ARB) in particular, when combined with calcium antagonists (CA), which have been proven to be metabolically neutral and able to reduce the risk of type 2 diabetes mellitus. A fixed-dose combination of the ARB losartan and the CA amlodipine has additional capabilities to affect the components of MS due to higher adiponectin and lower uric acid levels.
Place of angiotensin receptor blockers in the treatment of hypertension according to the latest recommendations of the 2013 European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) for the treatment of hypertension
Authors: Chukaeva I I , Solovieva M V , Litvinova S N
Published: February 2021

The following article provides the latest recommendations of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) 2013 for the treatment of hypertension. Particular attention is given to the group of angiotensin receptor blockers and irbesartan.
A modern phylogenetic theory of pathology, pathogenesis of essential arterial hypertension and universal algorhythm of damage to the target organs
Authors: Titov V N
Published: February 2021

Separate regulation of 2 arterial beds – phylogenetically early muscle arterioles (millions of local peristaltic pumps) and phylogenetically late proximal region, heart and elastic arteries – is the basis for the phenomenon that their non-coordination formed at different stages of phylogenesis manifests itself in functional disorders in paracrine cell communities. There is a small number of means to produce any effect on the paracrine cell community function at the level of the organism. Metabolic disorders in these communities can be normalized via the biological reaction of arterial pressure (AP). Pathogenesis of essential arterial hypertension is based on in vivo disorders of the biological functions of homeostasis, exotrophy, endoecology and adaptation. In essential hypertension, primary disorders form at the paracrine cell community level in the distal area of arterial bed, but not in the target organs. Only later, after compensatory activation of the biological reaction of AP and formation of discrepancy between regulations at the organism and paracrine cells communities, the process secondarily involves the target organs: kidneys, lungs and brains which have autonomous hemodynamics systems. The heart is the fourth target organ in essential hypertension. The pathogenesis of essential hypertension is based on phylogenetic discrepancy between metabolism regulation at the levels of the entire body and paracrine cell communities.
Practical aspects of fixed combinations in the treatment of hypertension
Authors: Ogarkov M Yu , Baranova M N , Skripchenko A E
Published: February 2021

Hypertension is a leading cause of heart attacks and strokes. Reaching target blood pressure (BP) in hypertension is the main condition optimization outlook for cardiovascular morbidity and mortality. To solve this problem in a substantial portion of patients, who are in need of antihypertensive drugs, wherein 70-80% of the target blood pressure can be achieved using a combination therapy. Fixed combinations of antihypertensive drugs increase treatment compliance and provide better organ protection. The new fixed combination of highly selective β-blocker bisoprolol and the calcium antagonist amlodipine can achieve target BP levels in 82,5% of patients with a minimum frequency of side effects.
New trends in the treatment of hypertension in 2013: the renaissance of pulse pressure
Authors: Ostroumova O D , Galeeva N Yu
Published: February 2021

The article examines the published data on the prognostic value of a high pulse pressure. Given is the position of European experts on the role of pulse pressure as a marker of target lesions limited hypertension.The possibilities of antihypertensive therapy in reducing the pulse pressure are also discussed.
The telmisartan and amlodipine combination in the treatment of hypertension
Authors: Shehyan G G , Yalymov A A , Schikota A M , Zadionchenko V S , Varentsov S I
Published: February 2021

The following review assesses socially significant disease - hypertension (AH) - and the problem of finding an effective antihypertensive therapy. Twynsta® drug (manufacturer Boehringer Ingelheim Pharma) - modern combined antihypertensive drug, which not only provides effective blood pressure control, but also due to the protective effect has been proved for all target organs improves the life expectancy of patients with hypertension. The clinical studies show that combination of telmisartan and amlodipine provides additional benefits in the treatment of patients with metabolic syndrome (by improving the carbohydrate and lipid metabolism), patients with impaired renal function (by inducing the regression of proteinuria), as well as left ventricular hypertrophy (by causing regression of the latter). The recently completed studies have shown that telmisartan acts as a selective PPAR-receptor modulator.In the present review it is shown that Twynsta® represents modern combined antihypertensive drugs and has a clinically proven favorable efficacy and safety profile.
Optimization of drug therapy of coronary heart disease and arterial hypertension: choice angiotensin-converting enzyme inhibitors
Authors: Trukhan D I , Tarasova L V
Published: February 2021

Important problem for the cardiologist and the first contact a doctor (therapist and general practitioner) is to optimize the therapeutic and preventive aspects of drug therapy in patients with coronary heart disease and arterial hypertension. The article considers the question of choice of ACE inhibitor from the standpoint of rational pharmacotherapy and evidence-based medicine.
The results of the open observational, international, multicenter, prospective program to assess the efficacy, safety and tolerability of the first direct renin inhibitor RasilezR (aliskiren) in patients with arterial hypertension in ‘real-life’ clinical practice settings (DRIve)
Authors: Chazova I Ye
Published: February 2021

Rasilez® (aliskiren) is the first drug from direct renin inhibitors class (DRI), which is used to treat arterial hypertension. The first aim of the «DRIve» program (Open observational, international, multicenter, prospective study to assess the efficacy, safety and tolerability of the first direct renin inhibitor Rasilez® (aliskiren) in patients with arterial hypertension in a real life setting) is to collect information about the efficacy, safety and tolerability of Rasilez (aliskiren) in monotherapy or in combination with other drugs in a real life setting for 6 months of therapy. Secondary aims were to analyze the patient acceptance of therapy and additional factors determining the outcome of Rasilez treatment. The program had been holding out from October 2009 until July 2011 in 17 cities of Russia.
Efficacy and safety of Mertenil (rosuvastatin) 40 mg in patients with familial hypercholesterolemia
Authors: Zubareva M Yu , Malyshev P P , Rozhkova T A , Kuharchuk V V
Published: February 2021

Familial hypercholesterolemia (FH) is an inherited disease that results in high levels of total cholesterol, causing the risk of early ischemic heart disease (IHD). Rosuvastatin is the high-potency hypolipidemic agent of HMG-CoA reductase inhibitors which is approved for clinical use.The goal of our research is to study efficacy, safety Mertenil (rosuvastatin) acceptability of maximal course dose of 40 mg in patients with phenotypic FH. Materials and methods. The 16-week open study was prospective. The study included 40 men and women at the age of 18 years and older with phenotypic FH. 18 patients had the Arg3500Gln mutation in APOB100 gene. Men accounted for 40% of total number of patients. The average age of patients was 55,9 years and average LDL cholesterol (LDL-c) level was 7,2 (1,2) mmol/l. Patients did not accept statins before the inclusion in this study (for a period no less than 3 months).Results. Rosuvastatin40 mg monotherapy 16 weeks study contributed to decrease LDL-c by 50% (p
Education and self-education of the patients is an important step towards increasing patients acceptance of therapy
Authors: Chazova I Ye , Ageev F T , Fofanova T V , Chikhladze N M , Kuznetsova M B , Smirnova M D , Ostrogorskaya V A , Geraschenko Yu S
Published: February 2021

The blood pressure level control and the long-term administration of anti-hypertensive agents are of high priority and play key role in treatment of patients with hypertension in the outpatient setting. This paper analyzes the short-term and long-term results of the education of patients with AH in a patient's School, and the effectiveness of the education concerning acceptance of therapy among these category of patients.Aim. To analyze received knowledge of the patients with arterial hypertension associated with LVH at patient's School compared to the control group and the study of the degree of patients acceptance of therapy and quality of life of both group of patients during the study.Material and methods. We underwent 13 cycles of education (course of education lessons with duration of 6 weeks, lessons 1 time per week). Topics and the duration of lessons (90 minutes), as well as the number of patients enrolled in the groups (8-10 people), corresponding to norms approved by the Ministry of Health of the Russian Federation. We educated 128 patients with AH (there were 66 patients with AH with out association with LVH and 27 patients, associated with LVH). The control group consisted of 65 patients with AH who had refused toattend patient's School for various reasons (41 patients without association with LVH and 24-associated with LVH).The Groups of patients educated/failed the education were matched by sex, age, duration of AH, BMI, levels of SBP and DBP. Instrumental and laboratory studies (general clinical examination, ECG, biochemical analysis of blood) were underwent before the treatment, at the end of the education cycle and in 24-months of outpatient treatment.Results. Patients who had been educated at the patient's School showed the statistically significant reduction of the BP level. In the end of School the systolic BP was 139,3±7,4 mm Hg and the diastolic BP - 86,2±5,4 mm Hg (p=0,0001). Patients in the control group also showed statistically significant reduction of BP during last visit, however, the degree of BP reduction in this group was statistically significant lower. The target BP was observed in 79% in the first group of patients and 54% in the second group of patients (p=0,003). Dynamics of the quality of life, estimated by the visual analog scale (VAS) was statistically significant higher in the group of patients, attending School (p=0,001). Acceptance of therapy among patients who had been visiting the School, significantly increased, but the statistically significant changes in acceptance of therapy in the second group of patients were not observed. Questioning and examination of the patients one year later, showed that in the group of patients who had received one cycle of education in the School, the BP level remained statistically significant below the basal value (SBP 142,3±5,7 and DBP 88,5±4,3 mm Hg, p
The mechanisms of developmentcardiovascular disease and type 2 diabetes: the role of insulin resistance, hyperinsulinemia and hypoadiponektinemia. Treatment and management
Authors: Shishkova V N
Published: February 2021

In the current paradigm, the primary insulin resistance plays a central role in the development of not only diabetes but also associated with cardiovascular complications, such as arterial hypertension, arteriosclerosis, heart failure, atrial fibrillation. Defense mechanism involves the secretion of adiponectin from adipoctyes and thus helps to block the development of these diseases. Modern antihypertensive treatment options of angiotensin-receptor blocker telmisartan show that, telmisartan can be used in patients with arterial hypertension because of improving insulin resistance and increasing adiponectin levels.
Psychosomatic Aspects of Low Adherence to Antihypertensive Therapy in Patients with Arterial Hypertension
Authors: Fofanova T V , Ageyev F T , Kadushina E B , Drobizhev M Yu , Smirnova M D , Kuzmina A E
Published: February 2021

Aim. To evaluate psychosomatic aspects of adherence to antihypertensive therapy (AHT) in patients with arterial hypertension and its relationships with comorbid somatic disturbances.Subjects and methods. A total of 161 patients with arterial hypertension with duration of more than 12 months (19 women, 42 men) aged 53,4±11,4 years were included in the study. All studied patients were followed up in the outpatient department of the Cardiology Research Institutenamed after A.L.Miasnikov, Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, and were consented for the psychiatric examination. To evaluate the patient adherence to AHT the following questionnaires and scales have been used: original Complaint Questionnaire designed by the authors for patients with arterial hypertension, USK, USK-B, ORB, GOTD, and patient self-reported Morisky-Green medication adherence scale. Consistent with data of patient case histories and responses to questionnaires, studied subjects were classified into two groups of adherence levels to AHT: Group I - 30 (19%) subjects; 17 women/13 men; mean age 52,9±11,7 years - included patients with high adherence to AHT, who started medication right after being diagnosed for arterial hypertension, and were treated regularly. Group II - 131 (81%) subjects; 102 women/29 men; mean age 53,1±11,8 years - included patients with low adherence to AHT, with postponed initiation of AHT after the diagnosis, and irregular or absent treatment.Results and conclusions. Patients comprising Group I with high adherence to AHT were characterized by short duration of arterial hypertension, crisis-type of its onset followed by panic attacks; concomitant disorders (ischemic heart disease, arrhythmias, ulcer disease, thyroid gland abnormalities), high anxiety level, panic attacks, anxiety and phobic paroxysms, subclinical depressions (dysthymia, cyclothymia), anxiodepressivesituational adaptation reactions, and nozogenic (adaptive) anxiodepressive reactions (hypernozognosia). Patients comprising Group II with low adherence to AHT were characterized by more severe affective symptoms (depressive and maniacal phases of bipolar affective disorder and recurrent depressions) and different variants of pathocharacterologic personality development.
Why occurrence of arterial hypertension with age becomes frequent?
Authors: Poseliugina O B , Poseliugina E B , Al-Galban N
Published: February 2021

Research objective: to study a table salt (PS) role in arterial hypertension (AH) increase with age.Material and methods. Examined 583 patients essential hypertension 1-2-th degree aged 25 to 59 years and 350 practically healthy persons - monitoring group. They investigated the threshold taste sensitivity to the PS (TTSPS) was determined daily urinary excretion of sodium ions with urine with the subsequent recalculation on the programme of the substation, which was received by the person with food in grams on the eve of research.Results. It appeared that in increase of AG accruing with age plays an undoubted role increase in consumption of PS. Thus the increase in consumption of PS is carried out involuntarily and is connected with decrease in sensitivity of the flavoring analyzer to Na. It, in turn, can be caused both age involution of the flavoring analyzer, and decrease in its sensitivity in connection with big consumption of PS.Conclusion. With age at sick AG of action for restriction of consumption of PS have to amplify only. It is possible to believe that at advanced and senile age in treatment of sick AG diuretics start playing rather big role.
The benefits of candesartan usage in the treatment of arterial hypertension
Authors: Ostroumova O D , Bondarets O V , Guseva T F
Published: February 2021

The article deals with the characteristics of angiotensin-II receptor antagonist pharmacokinetics. We have shown the differential characteristic of pharmacokinetics and pharmacodynamics of candesartan. The results demonstrate the clinical efficacy of candesartan in treatment of arterial hypertension (AH) and inreducing the risk of complications.
Angiotensin II receptor blockers in the treatment of arterial hypertension in patients with concomitant pathology: focus on candesartan
Authors: Trukhan D I
Published: February 2021

The results of numerous foreign and russian researches allow us to consider Candesartan as an important component of an effective therapy for patients with arterial hypertension, including the elderly, as well as with concomitant chronic heart failure, diabetes mellitus and other disorders in practice cardiologist and doctor of first contact (the therapist and general practitioner).
First results of the Russian database of international prospective observational registry variability of blood pressure in patients with hypertension
Authors: Ostroumova O D
Published: February 2021

The article presents the results of an analysis of the Russian part of the international registry of variability in blood pressure. It is shown that in a real clinical practice antihypertensive therapy reduces inter-visit variability of systolic and diastolic blood pressure. It has been found that the fixed combination of perindopril arginine / amlodipine has antihypertensive effect and its impact on the variability of systolic blood pressure exceeds that for other modes of antihypertensive therapy. Revealed patterns are characteristic also for subgroups of patients with a combination of hypertension and coronary heart disease, hypertension and diabetes.
Modern opportunities of monotherapy in patients with arterial hypertension associated with comorbid disorders
Authors: Gorokhovskaya G N , Yun V L
Published: February 2021

This article examines the modern approach to the treatment of arterial hypertension as one of the most important medical and social problems in the developed world, characterised by a high prevalence high risk of cardiovascular complications and occurrence along with comorbid diseases.
The combination therapy in arterial hypertension: opportunities of the fixed combination of irbesartan andhydrochlorothiazide(Koaprovel’)
Authors: Ostroumova O D , Guseva T F , Bondarets O V
Published: February 2021

The article deals with the various aspects of the combinationtherapyin arterial hypertension. We showed the complementary effects and benefits of the combination of angiotensin II receptor antagonistsand diuretics; also we described clinical caseswhere thiscombination therapy is forpriority use. In detail we analysed the literature data on the efficacy and safety of combination of irbesartan and hydrochlorothiazide, including long-term use.
Pharmacoepidemiological study of recommendations of diuretics for the treatment of hypertension in the outpatient setting
Authors: Ponomareva A I , Kompaniets O G , Linchak R M , Nemirovskaya M M , Strokan M V , Babich A E
Published: February 2021

The aim of the study is pharmacoepidemiologicalanalysis of the structureandreasonability of diuretic therapy in patients with hypertensive disease (HD)in ‘real-life’ clinical practicesettings.Materialandmethods:we underwentthe retrospectivepharmacoepidemiologicalcomparative analysisof the structureofdiuretic therapyreviewingoutpatient cardsfrom 2011 to 2014.We extracted data from outpatientcardsin outpatient department of Krasnodar Territoryusingcontinuous sampling method(421 patients)with the subsequent assessmentin accordance withmodern guidance materials. Results. In comparison with the regional study historic resultsthe administrationoftorsemidehad significantly increasedin patients withHD andnoncomplicatedchronic cardiac failure(12%).The priority drugs for the administrationamong diuretics werehydrochlorothiazide (24%)and indapamide (20%),spironolactone (20%).The ACE inhibitoror sartanusing in fixed combination with diuretic was recommended in 20% of out- patient cards.Structure ofdiuretic distribution in group of patients with HD, associated withCHF(II-IVfunctional class)had showedthe efficiencyof spironolactonein26%,of hydrochlorothiazide - 15%,torsemide - 13%,indapamide - 7%;the combination of spironolactoneandtorsemidewas receivedby 14% of patients,the combination of spironolactoneandhydrochlorothiazide - 6%,spironolactoneand furosemide - 1%,in 4% of outpatient cardswe noticed the triple combination of monocomponentdiuretic.Conclusion. We did not find unreasonable administration of diuretic therapy combination out ofindication and in the presence of contradictions.The prescription of modern long-termdiuretics associated with lower risk of side-effects developing will improve efficiencyand safetyof pharmacotherapy.It is very important to use fixed drugs combinationin case of administration the diuretic and agentsofrenin angiotensin system inhibitors.The volume and prescription reasonability analysis ofdiuretic therapy in patients withHDin ‘real-life’ clinical practicesettingshas shown compliance with modernnational guidance materials for the HD and CHF treatment.
Effect of sildenafil on clinical evidence and hemodynamic parameters in patients with pulmonary arterial hypertension, associated withsystemic rheumaticdiseases
Authors: Volkov A V , Udkina N N , Kurmukov I A , Nikolaeva Ye A , Nasonov Ye L
Published: February 2021

Timeliness of the topic: Pulmonary arterial hypertension(PAH), associated with systemic rheumaticdiseases(SRD),in particular with diffuse scleroderma, is a progressive disorder characterized by adverse outcomeespecially in lack of adequate treatment. Sildenafil 20 mg relaxes blood vessels and shows antiproliferative effect in patients with SRD.The aim of this paperis to study efficiency and safety of sildenafil in patients with PAH, associated with systemic rheumatic diseases.Material and methods:we have been monitoring the 16-week therapyin 14 patients with PAH, associatedwith systemic scleroderma (12 patients) and systemic lupus erythematosus (2 patients). The efficiency was assessed by the dynamics of clinico-laboratorial indices, central hemodynamics were evaluated using the right heart catheterization before the study and after 16 weeks of treatment.Results:We marked thatthe walkeddistancehad been increased by 31 meterinsix-minute walking testduring the therapy;we also saw the improvement of thefunctional classin 29% of patients.The significant improvement achieved in evaluating the hemodynamic parameters.A significant reduction of mean pulmonary arterial pressure was determined from 50.4 ± 9.2 mm Hg to 40.7 ± 10.2 mm. (p = 0.002), the pulmonary vascular resistance fell from 9.5 ± 5.9 to 6.4 ± 3.7 Wood units(p = 0.05),as well assome of the other indicators decreased.Right atrial pressurefell from8.3 ± 5.5 mm Hg. to 6.5 ± 3.1 mm Hg,we noticedthe stabilizationof left ventricle systolic function indices, thus,cardiac indexin all 14 patients,participatingin our study,had not been undergoingsignificant changes (3.1 ± 0.9 l/min/m2at the beginning of the study and 3.1 ± 0.7 l/min/m 2after 16 weeks of the therapy).The risk level, using scale register REVEAL, significantly decreased frommoderate high (9.0 ± 2.0)to medium (8.2 ± 1.9), (p = 0.04).There were no serious adverse events during the 16-week treatment using sildenafil. Three patients showed predisposition to hypotension, but, the blood pressuredecreased within the normal rangesin total group. Skin changes characterized bydermahemia ("blush") were observed in 4 patients and did not significantly impact on the general well-being of patients.Conclusion: Thus, Sildenafil 20 mgshowedefficiency and safety and could be used in treatment patients with PAH, associated with SRD.
Beta-adrenergic blocking agent in cardiovascular disease: focus on metoprolol
Authors: Baryshnikov G A , Stepanova I I , Kudryavtseva N A
Published: February 2021

This article presents the data on the therapeutic efficacy ofbeta-adrenergic blocking agentsin ischemic heart disease, chronic heart failure (CHF), arterial hypertension. We analyzed the basic pharmacological mechanism of action of these drugs class. The comparison of pharmacodynamic and pharmacokinetic characteristics of metoprolol succinate retard with other beta-adrenoreceptor-blocking agents showed metoprolol succinate advantage over the short-term drugs for treatment of CHF. According to the results of randomised clinical trialswe determined high therapeutic efficacy and safety of metoprolol succinate retard.
Perindopril is angiotensin-converting enzyme inhibitor in treatment patients with arterial hypertension
Authors: Martynov A I , Urlaeva I V , Akatova Ye V , Nikolin O P
Published: February 2021

According to the 2013 ESH guidelines, it is possible to use any group of known antihypertensive drugs in the treatment of arterial hypertension. But we often have been using different combinations of drugs. In this situation, using drugs combination in fixed dosage increases patients acceptance of therapy and makes treatment easier. According to the results of the numerous studies, perindopril statistically significant reduces total and cardiovascular mortality and the incidence of myocardial infarction. The combination of perindopril and calcium antagonist makes the drug more effective.
Nebivolol for treatment patients with arterial hypertension
Authors: Mikheeva O M , Komisarenko I A
Published: February 2021

Beta-adrenergic blocking agent is included in the group of primary agentsfor treatment of patients with AH. In the pathogenesis of AH,one of the main causes leading to raisingthe blood pressure isendothelial dysfunction.Correction ofendothelial dysfunctionis AH treatment strategic aim.Nebivololis a cardioselectivethird-generationvasodilatingβ-adrenergic blocking agent, which is in addition toβ-adrenergic blocking effect, can alsoincrease endogenousproduction of NOin the endothelial cellsdue to the decreasing of oxidative degradation. As a result,nebivololprovides positivehemodynamic effects on patients with AH, decreasingperipheral resistanceandblood pressure.
Arterial hypertension and brain damage. New targets of therapy
Authors: Yanishevskiy S N , Mirnaya D A , Andreyev R V
Published: February 2021

Objective: to assess the feasibility of ARBs to reduce hypoperfusion of the brain that develops in patients with arterial hypertension of 1-2 degrees. Material and methods. A study of changes in the ultrasonic Doppler index (RI resistivity index and pulsatility index PI) and the structure of neurological symptoms in patients with arterial hypertension of 1-2 degrees (n=86) due to 53-week olmesartan medoxomil reception (Cardosal®). Results. Patients with arterial hypertension of 1-2 degrees have diagnosed diffuse neurological symptoms and mild cognitive impairment. Doppler ultrasound revealed an increase in peripheral resistance index in the internal carotid and middle cerebral arteries, compared with patients without hypertension. Through 53 weeks therapy of olmesartan medoxomil (Cardosal®) observed a statistically significant decrease in peripheral vascular resistance (p
Fibromuscular dysplasia as the cause of malignant renovascular hypertension in a newborn
Authors: Albot V V , Dolgikh V V , Gvak G V , Pogodina A V
Published: February 2021

Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory arteriopathy, which can affect arteries of any part of vascular system and is most commonly diagnosed in women between 20-60 years of age. We present the FMD case study of ischemic stroke in a 10-month-old child, manifested in the hospital. The application of diagnostic methods is not allowed to determine the cause of uncontrolled arterial hypertension development in patient during the life. Pathologic study revealed the generalized tubular fibromuscular vascular dysplasia affecting arterial vessels practically of all parts of vascular system and forming stenotic areas of both of the renal arteries, the arteries of the heart, brain, intestines, liver and spleen.Conclusion. FMD manifestation during the period of infancy is associated with severe course and poor prognosis. The improvement of the prognosis for this disease, obviously, can be achieved in case of the diagnosis the disease before the development of organ complications, what is required the monitoring of blood pressure level during the routine pediatric examinations in children of the first year of life, even in the absence of complaints.
The hardness of the vessel wall in patients with arterial hypertension
Authors: Ostroumova O D , Kochetkov A I , Kopchenov I I , Guseva T F , Bondarec O V
Published: February 2021

The article deals with the role of the hardness of the vessel wall in the pathogenesis of arterial hypertension and its complications and cardiovascular mortality. We discussed the factors increasing the hardness of the vessel wall, such as age, blood pressure level, atherosclerosis, smoking and diabetes mellitus. We showed the indicators reflecting the status of the vascular wall and which could play a role of markers of increased risk of cardiovascular complications. We reviewed the data concerning the improvement of the parameters of the hardness of the vessel wall under the influence of antihypertensive therapy using the angiotensin II type 1 receptor blocker - candesartan. We discussed the possible mechanisms of the candesartan influence on the elastic properties of the vessels. We stressed that the effect on the hardness of the arteries on using antihypertensive drugs, even within the same class, was different, which, apparently, was associated with the difference in the pharmacokinetic properties.
Influence of metabolic syndrome components on the level of nitric oxide stable metabolites in patients with essential hypertension
Authors: Podzolkov V I , Bragina A E , Bragina G I , Murashko N A
Published: February 2021

Objective. To investigate levels of the stable nitric oxide metabolites (NOx) in relation to different components of the metabolic syndrome (MS) in essential hypertension (EH).Methods. We examined 124 untreated patients with EH and 25 healthy volunteers with comparable age.Results. NOx levels were significantly higher in hypertensives (43.18±21, mol/l) then in controls (28.3±9.6 mol/l); p
The recommendations review concerning the maintenance of patients with arterial hypertension: evidence and expert opinions
Authors: Samorodskaya I V , Boitsov S A
Published: February 2021

The article presents the comparison study of 4 English-language recommendations of professional communities during 2013 year concerning the methods used for formulating recommendations; blood pressure levels - BP (primary, threshold and target); the group of primary agents and the treatment regimens.Conclusions. Different methods for formulating recommendations and the use of expert opinions in the absence of the evidences can lead to certain differences in the recommendations. It is not enough being agreed upon the questions concerning the primary and target BP level in elderly patients, the use of b-blockers as the group of primary agents, nowadays and the recommendations show the different treatment regimens.
The role of beta-blockers in the treatment of arterial hypertension: what do we know today
Authors: Zhernakova Yu V , Chazova I E
Published: February 2021

Beta adrenergic receptor blocking agentsare one of the multi-function classes of the drugs, prescribing to treatvarious cardio-vascular diseases, and at the same time, this class have been mostly discussing for several years due to the number of publications with the critical comments and rule this class of drugs out from priority groups for the treatment of arterial hypertension (AH), as, for example, it took place in the United Kingdom and the United States. However, national guidelines for the diagnosis and treatment of arterial hypertension (AH), as well as the guidelines from the European Society of Hyper- tension keep the same position on the β-blockers, including them on equal ground with list of 5 major classes of antihypertensive drugs to treat AH.
The efficacy offixed combination of bisoprolol and amlodipine in patients with arterial hypertension, ischemic heart disease and metabolic syndrome
Authors: Skibickiy V V , Fendrikova A V , Skibickiy A V , Syrotenko D V
Published: February 2021

The aim of the studyis to evaluate the efficacy of the fixed combination of beta adrenergic receptor blocking agents (β-AB) bisoprolol and dihydropyridine calcium channel inhibitor (CCI) amlodipine in patients with uncontrolled arterial hypertension (AH), stableischemic heart disease (IHD) and metabolic syndrome (MS) in actual clinical practice.Material and methods. The study enrolled 61 patients with uncontrolled AH, stable IHD and MS in the open prospective randomized study. The patients were randomized into 2 groups, using opaque and sealed envelopes. Patients in group 1 (n =30) had been receiving angiotensin-converting enzyme inhibitor (ACE inhibitor or ACE-i) - ramipril in dose of 10 mg/day (Hartil, Egis), fixed combination of bisoprolol and amlodipine (Concor AM, Takeda) in different doses. Patients in group 2 (control, n=31) should have been treated at the discretion of the doctor, necessarily the treatment should have included the free combination of ACE inhibitors, generic b-AB and dihydropyridine CCI. Initially, and after 12 weeks of treatment we conducted 24-hour ambulatory blood pressure monitoring (APBM) with the assessment of key indicators of 24-hour blood pressure monitoring results, the parameters of the blood vessel hardness and central blood pressure. The Statistical analyses of the results were carried out using the software package Statistica 6.1 (StatSoft Inc., United States).Results. After 12 weeks of therapy, the target level of BP was - 96,7% in the 1st group and 87,1% in the 2nd group of patients. The application of Concor AM was accompanied by significant improvements of the indicators of APBM and of the blood vessel hardness and central blood pressure characteristics. In addition, the usage of Concor AM provides the normalization of 24-hour ambulatory blood pressure monitoring results in 73% of patients. In the control group we determined the positive, but less significant changes in the indicators of APBM and rarer normalization of 24-hour ambulatory blood pressure monitoring results than in the group of patients, administrating Concor AM.Conclusion. In patients with AH, IHD and MS the administration of Concor AM is provided a significant antihypertensive and vasoprotective effects, which are more effective by the side of using free combination of β-AB and dihydropyridine CCI.
Functional state of kidneys and arterial hypertension among indigenous and nonindigenous residents of Mountain Shoria
Authors: Ogarkov M Yu , Filimonov E S , Mulerova T A , Kuzmina A A
Published: February 2021

Goal: to investigate the interrelation between arterial hypertension and functional state of kidneys among indigenous and nonindigenous Mountain Shoria residents.Material and methods. 370 Mountain Shoria residents (consisting of 113 men and 257 women) were examined. All examinees were 51,07±1,46 and 52,93±0,96 years old on average. The level of blood creatinine was determined by all examinees. Its clearance was calculated according to the Cockcroft-Gault formula in order to determine the glomerular filtration rate. The calculated values were matched with the average square of the body surface (approximately 1,73 square meters). The whole statistical processing was carried out with the help of the Statistica 6.1 programme, significant differences were accepted at p
The prevalence of renal dysfunction in arterial hypertension (in the framework of the ESSE-RF study)
Authors: Oshchepkova E V , Dolgusheva Iu A , Zhernakova Iu V , Chazova I E , Shal'nova S A , Iarovaia E B , Rotar' O P , Konradi A O , Boitsov S A
Published: February 2021

Objective. To study the prevalence of renal dysfunction, its relation with arterial hypertension and metabolic risk factors.Materials and methods. Data from the ESSE-RF study from 10 regions of the Russian Federation are presented. Renal dysfunction was assessed on the basis of the calculation of glomerular filtration rate (GFR). GFR calculation was conducted on the Chronic Kidney Disease Epidemiology Collaboration (GFR-EPI).Results. The study reveals a high prevalence of GFR decline in the population studied (76.8% in women and 23.2% in men). More unfavorable situation was found among the patients with hypertensionand in patients with hypertension and impaired glucose metabolism or diabetes mellitus, in which the prevalence of decrease GFR was higher than in patients without hypertension and without impaired glucose metabolism or diabetes mellitus.Conclusion. Prevalence of renal dysfunction among the Russian population is defined. Associations of reduction in glomerular filtration rate with cardiometabolic risk factors are revealed.
Fixed dose combinations for the treatment arterial hypertension: the real way to improve control
Authors: Morozova T E , Andreev S S
Published: February 2021

Insufficient control of blood pressure levels of the essential hypertension in Russia (less than 30% for women, less than 20% for men) was proven by epidemiology trials. This article is a review of the present opportunities to increase efficacy of treating hypertension by application of combined anti-hypertensive therapy and the advantages of fixed dose combinations (FDC). The authors scientifically prove the importance of using the combination, including angiotensin I-converting enzyme perindopril arginine and the long-half time dihydropyridine calcium channel blocker amlodipine in various clinical cases. Also the article summarizes the research of real clinical practice proving the high efficiency and safety of perindopril arginine /amlodipine FDC.
Radiofrequency denervation of renal arteries. Myth or reality?
Authors: Grigin V A , Danilov N M , Matchin Yu G , Chazova I E
Published: February 2021

Resistant hypertension is an urgent problem in modern cardiology, leading to myocardial infarction, stroke, and, as a consequence, early disability of patients. The emergence of such a method as radiofrequency denervation of the renal arteries in the complex antihypertensive therapy can expect to achieve control of blood pressure and thus reduce the risk of cardiovascular complications. This article presents the current state of the use of this method in clinical practice.
Current possibilities of nuclear imaging in arterial hypertension
Authors: Ansheles A A , Sergienko V B
Published: February 2021

The review represents current possibilities of nuclear imaging methods in assessment of the functional status of various organs and biological processes in arterial hypertension.
Diuretics in combination antihypertensive therapy: focus on forecast
Authors: Chazova I E , Martyniuk T V
Published: February 2021

In the modern therapy of arterial hypertension (AH) along with thiazide diuretics b-blockers, calcium antagonists, angiotensin converting enzyme inhibitors and angiotensin receptor blockers are considered for initial and maintenance of antihypertensive therapy in the form of mono - or combination therapy. Five of these classes of drugs have comparable antihypertensive effectiveness and proven impact on prognosis in accordance with the results of randomized controlled clinical trials. The most widely used in clinical practice for the treatment of patients with AH received thiazide diuretics. The most powerful evidence base among the diuretics in regards to the effect on prognosis is chlortalidone. The article presents data from a randomized, placebo-controlled and comparative studies сhlortalidone and hydrochlorothiazide in AH. It is shown that diuretics are the most effective component of combination therapy. The application of a new fixed combination сhlortalidone in combination with azilsartan medoxomil in our country will improve opportunities for effective treatment of this category of patients.
The possibility of perindopril in angioprotective in patients with metabolic syndrome after combination therapy with a thiazide diuretic
Authors: Nedogoda S V , Smirnova V O , Khripaeva V Yu , Palashkin R V , Ledyaeva A A , Chumachok E V , Salasyuk A S
Published: February 2021

Aim. To assess the possibility of monotherapy with perindopril after transferring from combination therapy with losartan and hydrochlorothiazide with respect to correction of the anthropometric, metabolic parameters, premature vascular aging and vascular elasticity in patients with metabolic syndrome. Material and methods. Held open prospective controlled study of 50 patients with metabolic syndrome (IDF, 2005), which reached BP