bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical case of rheumatoid arthritis with antiphospholipid antibody syndrome
Authors: Arabidze G. G , Shapchenko A. V , Muslimova O. V , Larina O. Yu , Sorokoletov A. M
Published: February 2021

The article presents a clinical case of development of secondary antiphospholipid syndrome (APS) with early active rheumatoid polyarthritis, complication in the form of acute deep vein thrombosis of forearm on the left and chronic left vein thrombosis of the lower extremity. Patient treatment with methotrexate has developed an infectious complication and resulting in the need to go to therapy of leflunomide. This therapy have positive effect. In a survey of the patient revealed a rare form of adrenal pheochromocytoma confirmed by computed tomography and measurements of plasma normetanephrine, but not accompanied an increase of blood pressure. This article discusses the modern classification of APS, pathogenesis, clinical and laboratory diagnostic criteria, methods of therapy as rheumatoid arthritis, and APS.
Acetylsalicylic acid in the treatment of cardiovascular diseases
Authors: Zadionchenko V. S , Yalymov A. A , Shchikota A. M , Shehyan G. G , Ly V. V
Published: February 2021

The problem of atherothrombosis and associated diseases is examined here. The estimation of an enteric form of acetylsalicylic acid (a drug Thrombo ASS) from the perspective of evidence-based medicine is also discussed. The use of acetylsalicylic acid in primary and secondary prevention of cardiovascular diseases is demonstrated.
Magnetolaser therapy and piloerection in medical rehabilitation of adolescents with connective tissue dysplasia
Authors: Dubilei G. S , Goreva I. Iu
Published: February 2021

In the article assesses the effectiveness of differentiated application of magnetic therapy and piloerection in adolescents with the syndrome of a vegetative dystonia with connective tissue dysplasia.
Association of polymorphisms of chromosome 4q25 in patients with atrial fibrillation
Authors: Shulman V. A , Nikulina S. Yu , Poplavskaya E. E , Maksimov V. N , Aksyutina N. V , Nazarov B. V
Published: February 2021

The article deals with the issue of genetic determination of atrial fibrillation. In particular, it is shown that a rare polymorphism rs2200733 T allele on chromosome 4q25 statistically more frequently (p=0,029) in patients with atrial fibrillation compared with the control group data. The question of the functional significance of this polymorphism in the development of electrical instability of the atrial myocardium is also addressed.
Reduced progression of atrial fibrillation in hypertensive patients with long-term treatment of propafenone
Authors: Tarzimanova A. I , Podzolkov V. I
Published: February 2021

In recent years, progress has been made in the study of the natural history of atrial fibrillation (AF) - that, from the stage of having no clinical manifestations, to the final stage, which is an irreversible arrhythmia, is associated with the development of serious cardiovascular complications. Most AF patients steadily progress in persistent or permanent form, but the risk factors and predictors of progression of the arrhythmia is not clearly defined. There is little research done on the effect of long-term antiarrhythmic therapy on the progression of AF. Objective. To evaluate the progression of arrhythmias in patients with arterial hypertension (AH) with paroxysmal AF in the treatment of propafenone (propanorm) compared to treatment with bisoprolol (Concor) in the long-term prospective study. Materials and methods. The study included 62 patients with essential hypertension aged 45 to 63 years. Patients were randomized into 2 groups: 32 patients in group 1 for storing heart rate propafenone took a daily dose of 450 mg, 30 patients in group 2 to control ventricular rate was appointed bisoprolol. Prospective monitoring of patients was carried out from 2011 to 2015, the progression of the arrhythmia was considered: increase in the frequency of paroxysms of arrhythmia in the last 3 months, the appearance of long-term persistent AF episodes or persistent AF. Results. In 14 (44%) patients in group 1 and 20 (67%) - group 2 5 years of observation, it was noted increase in the frequency and duration of AF episodes. The average value of arrhythmia progression into a more stable form of 9.3% per year in patients receiving propafenone, and 11.5% - bisoprolol (p=0.007). Keeping the treatment of sinus rhythm propafenone in a daily dose of 450 mg contributed to a significant reduction of the left atrium anteroposterior size from 43±3 to 36±3 mm (p=0.03). In the treatment with bisoprolol anteroposterior size of the left atrium was not significantly changed and amounted to 44±3 and 43±3 mm respectively. Portability of propafenone antiarrhythmic therapy was comparable with that of bisoprolol. No severe or serious side effects were observed in patients during the long-term prospective study. Conclusion. The five-year propafenone treatment of hypertensive patients with paroxysmal AF can reduce the progression of AF in a more stable form compared with bisoprolol therapy.
Features of zofenopril and enalapril in patients with stable ischemic heart disease in combination with arterial hypertension
Authors: Evdokimova A. G , Smetanin A. V , Evdokimov V. V , Kovalenko E. V , Kiyakbaeva E. V
Published: February 2021

Objective. Optimization of drug therapy in patients with stable coronary heart disease and arterial hypertension (AH) in the application of ACE inhibitors: zofenopril compared with enalapril. Material and methods. We studied 80 patients with stable angina II-III functional class (FC) and AG 1-2 degree (Mean age 58.8±8.8 years) who were randomly divided into 2 groups of observation for 40 people in each: 1 - receiving zofenopril, 2 - enalapril - composed of basic therapy consisting of nitrates, .-blocker, statin, aspirin. The duration of follow-up was 6 months. At baseline and in the dynamics of all patients underwent clinical, laboratory and instrumental studies. It evaluated the quality of life through «Seattle questionnaire» for patients with angina. The daily monitoring of blood pressure at the same time with an electrocardiogram, treadmill test according to the modified protocol R.Bruce, echocardiography was conducted. Conclusion. The use of zofenopril, more than enalapril leads to significantly improved quality of life, exercise tolerance, normalizes the diurnal profile of blood pressure, reduces episodes of ischemia.
The value of naturally preformed factors of Nalchik in the rehabilitation of women with hypertension
Authors: Apsheva E. L , Elgarov A. A , Kalmykova M. A , Elgarov M. A
Published: February 2021

The comparable therapeutic efficacy of balneotherapy with bromyoid and nitrogen-thermal baths in women with hypertension in the resort of Nalchik and the role of a spa treatment in the system of restorative treatment and rehabilitation are confirmed.
Prognostic factors of cardiovascular death in patients with ischemic stroke in the long-term follow up
Authors: Fonyakin A. V , Geraskina L. A , Shandalin V. A
Published: February 2021

In a prospective observational non-interventional study included 148 patients with ischemic stroke at the age of 60 (52; 68) years, with sinus rhythm. At the end of the acute stroke period (21-22 days) was performed Holter monitoring with the assessment of arrhythmias and heart rate variability (HRV). Duration of prospective follow-up was 35 (28; 40) months. We register all cases of cardiovascular death (CD), including death due to recurrent stroke, myocardial infarction (MI), sudden CD (SCD), acute heart failure (AHF), pulmonary embolism. During follow up CD was registered in 15 (10%) patients: in 7 patients - due to recurrent stroke, 2 patients - due to acute MI, in 3 - due to AHF, 3 patients - due to SCD. On multivariate regression analysis in sinus rhythm revealed significant association with the development of CD following factors: age over 67 years, male gender, involvement insula in the area of ischemic damage, supraventricular extrasystoles (more than 54 extrasystoles per day), ventricular arrhythmias, bradyarrhythmias, reduced power range of high-frequency (HF) less than 39 ms2 and low frequency less than 180 ms2 HRV. Separately from the number of these factors with increased risk of fatal complications was significantly associated only two parameters: the involvement insula in the cerebral infarct area (p
Acute coronary syndrome: pathogenesis, diagnosis, treatment, rehabilitation (Lecture 3)
Authors: Perepech N. B
Published: February 2021

The lecture discusses methods of ensuring hemodynamic and neurohormonal unloading of the heart, current recommendations for the prevention of exacerbations of coronary heart disease in patients with myocardial infarction or unstable angina episode. Narrow organizational, diagnostic and therapeutic tasks that need to be addressed at the stage of hospital treatment of patients with acute coronary syndrome. Substantiates the principle of modular construction of individual rehabilitation programs, discussed methodological procedures of obtaining and analyzing the information necessary for the individualization of rehabilitation programs, as well as methods of physical, mental rehabilitation and disability assessment of patients after myocardial infarction.
Acute coronary syndrome: pathogenesis, diagnosis, treatment, rehabilitation (lecture 2)
Authors: Perepech N. B
Published: February 2021

The lecture discusses the current methods of pain relief, inhibition of thrombus formation process in the coronary artery, restoring blood flow in the coronary artery and prevent it retrombosis in patients with acute coronary syndrome. The results of large randomized clinical trials of the effectiveness of antiplatelet agents, anticoagulants, fibrinolytic agents, indications for their use and dosing regimens. The results of clinical application of non-drug methods of restoration of coronary blood flow. Settle guidelines for choosing the optimal strategy for patients with acute coronary syndrome, depending on the characteristics of myocardial injury and the degree of cardiovascular risk.
Diagnosis, prevention and treatment of chronic heart failure: what the therapist of the outpatient health care unit should know (according to the recommendations of the European Society of Cardiology for the diagnosis and treatment of acute and chronic heart failure in 2016)
Authors: Larina V. N , Chukaeva I. I , Bubnova M. G
Published: February 2021

In the article, the main provisions of the recommendations of the European Society of Cardiology and the Association for Heart Failure 2016 are presented in the abstract. The new classification is presented, the approaches to diagnostics and pharmacological treatment of chronic heart failure are highlighted, attention is paid to the prevention of development of clinically significant heart failure and multidisciplinary approach in managing patients with this pathology.
Morphofunctional state of the brain in chronic heart failure
Authors: Akimova N. S , Sokolov I. M , Martynovich T. V , Shvarts Yu. G
Published: February 2021

The aim of the study was to examine the dependence of functional and morphological changes in the brain and factors of the severity of chronic heart failure. Materials and methods: 54 patients with chronic heart failure of ischemic genesis, I-IV functional class were cognitive tests, echocardiography, nuclear magnetic resonance imaging of the brain. Results. With an increase in the functional class of chronic heart failure, the worst results of Veksler-5 and 7 cognitive subtests are noted, a smaller thickness of gray matter of parietal lobes, lower diffusion coefficients of water molecules in the white matter of the parietal and occipital lobes, and a smaller thickness of the middle legs of the cerebellum. Comparative analysis of the central nervous system state indices in patients with chronic heart failure with different fraction of left ventricular ejection did not show significant differences. The conclusion. The established results confirm the significance of the functional class of chronic heart failure as a marker of cognitive dysfunction and pathological changes in both gray and white matter of the brain, whereas the size of the left ventricular ejection fraction is obviously less useful in this respect.
Impact of drug therapy on the risk of death in patients with coronary heart disease (according to the data of registry of cardiovascular diseases, RECVASA)
Authors: Pereverzeva K. G , Yakushin S. S , Vorobyev A. N , Lukyanov M. M , Andreyenko E. Yu , Zagrebelny A. V , Deev A. D
Published: February 2021

The aim of the study was to evaluate the effect of the drug therapy assigned at the index visit on the risk of fatal outcome in outpatients with coronary heart disease within 24 months from the index visit, based on the data of registry of cardiovascular diseases (RECVASA). Follow-up feedback was 97.4%, the survival rate - 90.6%. The study found that the prescribing of angiotensin-converting enzyme (ACE) inhibitors or ACE inhibitors/angiotensin receptor blockers II (ARB) was associated with reduction of all-cause mortality by 1.6 times (p=0.016) and 2.0 times (p=0.006), respectively, statins - by 1.6 times (p=0.038). The risk of death from cardiovascular causes in the case of prescribing of ACE inhibitors or ACE inhibitors/ARBs decreased by 2.1 times (p=0.0008) and 2.3 times (p=0.0008), respectively, statins - by 1,7 times (p=0.048).
The role of galectin-3 in the diagnosis and control of the effectiveness of pharmacotherapy of chronic heart failure
Authors: Giamdzhian K. A , Kukes V. G
Published: February 2021

Relevance. At present, it is urgent to develop new biomarkers that can serve as a tool for early diagnosis of the disease in order to select pharmacotherapy and further monitor its effectiveness. The goal is to evaluate the clinical value of the definition of galectin-3 in patients with chronic heart failure (CHF). Materials and methods. The study included 53 patients (31 women, 22 men) with CHF II-III functional class (FC) of the New York Heart Association (NYHA). The mean age of the patients was 71 years (95% confidence interval 68.99-74.37). A group of patients with NYHA FCh II CHF made up 14 people, a group of patients with NYHA-39 CHF III FC. The median of the initial level of the N-terminal brain natriuretic peptide (NT-proBNP) was 65.7 pmol/L, the median of the initial level of galectin-3 - 8.37 pmol/l. Results. The relationship of increased level of galectin-3 with reduced ejection fraction,% (r=-0.26, p=0.04), increased creatinine level (r=0.26, p=0.04) and increased level of NT-proBNP plasma (r=0.3, p=0.02). With other clinical indicators, such as systolic and diastolic blood pressure, heart rate, body mass index, 6-minute walk test, left ventricular mass index, glucose level, total cholesterol, glomerular filtration rate, no statistically significant association was found. A moderate correlation was obtained between the levels of NT-proBNP and galectin-3 plasma (r=0.3, p=0.02). Reduction in the level of galectin-3 after the treatment was detected in 84.3% of patients. The conclusion. Galectin-3 can serve as an additional diagnostic biomarker of CHF.
Acute coronary syndrome: treatment strategies (part 1)
Authors: Perepech N. B
Published: February 2021

Two cases of medical care for patients with acute coronary syndrome are discussed, in which conservative and invasive treatment strategies were applied. The clinical aspects of thrombolytic therapy and percutaneous coronary interventions, the use of antiplatelet agents and anticoagulants for the prevention of atherothrombotic events after the restoration of blood flow through the infarct-responsible coronary artery are considered.
High-intensity therapy: rationale, indications and safety issues. Prospects of rosuvastatin in clinical practice
Authors: Bubnova M. G
Published: February 2021

The review is devoted to the problem of high-intensity therapy. Evidence of the effectiveness of statin prescribing in high-intensity mode is presented to patients with very high cardiovascular risk. Indications for such therapy and its principles are indicated. The issues of tolerability and safety of high-intensity therapy are considered.
Clinical efficacy and cardioprotective capabilities of olmesartan and lercanidipine in the form of monotherapy and with their combined use in patients with arterial hypertension 1-2 degree
Authors: Evdokimova A. G , Ryzhova Yu. V
Published: February 2021

The aim of the study was to evaluate the clinical efficacy and cardioprotective effects of olmesartan and lercanidipine in the form of monotherapy and combined use in patients with arterial hypertension (AH) 1-2 degree and the presence of target organ damage in the form of left ventricular hypertrophy (LVH) and microalbuminuria UIA). Materials and methods. 90 patients with AH of 1-2 degree were examined and presence of LVH according to echocardiography (EchoCG) data, middle age 50.3±4.3 years, 42 of them men and 48 women, with AH of 1st degree - 44 (48.9%) people, with AH of the 2nd degree - 46 (51.1%) people. The mean duration of hypertension was 6.8±1.5 years. Methods included daily monitoring of blood pressure (cardiovascular system): CardioTens (Meditech, Hungary), transthoracic EchoCG: Voluson 730 Expert (General Electric, USA). One of the inclusion criteria was the presence of LVH according to EchoCG data: more than 95 g/m2 in women and more than 115 g/m2 in men. Depending on the initial degree of hypertension patients were divided into 3 groups. Patients with the 1st degree of AH were randomized to olmesartan monotherapy with 10-40 mg/day (group 1) and lercanidipine 10-20 mg/day (group 2), with grade 2 AH included in the combination therapy group Studied drugs (3rd group). Doses of drugs were titrated until the target blood pressure levels were reached. Initially and after 6 months of therapy, the results of SMAD, EchoCG were evaluated, the quality of life of patients was assessed using the visual-analogue scale "Health thermometer". The statistical analysis was carried out using the program Statistica 7.0. Results of the study. The degree of significant decrease in blood pressure in comparison with the baseline values and the corrective effect on the daily profile of blood pressure were comparable in the monotherapy groups with olmesartan and lercanidipine. In the group of combined use of target drugs of target levels, blood pressure was achieved in a larger percentage of cases than in the monotherapy groups. A reliable cardioprotective effect of olmesartan and lercanidipine was revealed both in monotherapy and in combination in patients with AH of 1-2 degree with LVH and MAU, manifested by a decrease in LV mass index (LVMI). The greatest cardioprotective effect in LVH regression was achieved in the combination therapy group. Conclusion. Olmesartan and lercanidipine when used in monotherapy have a cardioprotective effect in the form of a reliable and comparable decrease in LVMI, and their use in combination has a more pronounced effect on LVH regression.
Diurnal blood pressure variability as a risk factor for complications of arterial hypertension
Authors: Ostroumova O D , Reznikova K U
Published: February 2021

The paper gives the definition of blood pressure variability and lists its types. It considers the value of diurnal blood pressure variability as an independent risk factor of stroke and myocardial infarction in arterial hypertension. The authors present the data of their study of the effect of a fixed-dose combination of amlodipine and lisinopril on diurnal blood pressure levels and variability.
Diuretics in arterial hypertension: a focus on torasemide
Authors: Baryshnikova G A , Stepanova I I
Published: February 2021

Diuretics have been long used to treat arterial hypertension; however, the use of loop diuretics has been limited by cases of chronic kidney and heart failure. The loop diuretic torasemide is now administered in subdiuretic doses (2,5–5 mg) to treat arterial hypertension; it is well tolerated, metabolically neutral, and, due to its antialdosterone effect, fails to cause hypokalemia.
B-ADRENOBLOCKERS IN THERAPY FOR ARTERIAL HYPERTENSION: ON THE WAY TO REASONABLE COMPROMISE
Authors: Perepech N B , Shurygina V D
Published: February 2021

The paper discusses the aspects of using b-adrenoblockers in the treatment of patients with arterial hypertension (AH). It discusses the reasons why United Kingdom experts have excluded b-adrenoblockers from the list of first-line antihypertensive drugs. The place of b-adrenoblockers is defined among other antihypertensive agents according to the European and Russian guidelines for the management of hypertensive patients. The authors show indications for the use of different b-adrenoblockers in patients with AH and underline the need for an individual approach to choosing a b-adrenoblocker and the expediency of administering long-acting cardioselective drugs as agents having an optimal combination of their efficacy and safety.
Organ-protective effect of fixed-dose combination antihypertensive therapy with eprosartan and hydrochlorothiazide for subclinical and clinical target organ damage in hypertensive patients
Authors: Koziolova N A , Bushmakina A V , Kovalevskaya N A , Shatunova I M
Published: February 2021

Aim: to evaluate the efficiency of starting fixed-dose combination therapy with eprosartan and hydrochlorothiazide on the clinical and subclinical parameters of target organ damage in patients with hypertensive disease (HD) irrespective of baseline blood pressure (BP) and cardiovascular risk. Subjects and methods. The study consisted of two parallel substudies. Substudy 1 that screened 3536 workers from industrial enterprises identified 395 (13%) hypertensive patients. Among them, there were 50 (12,7%) untreated patients with HD who had three-component target organ damages: left ventricular hypertrophy, hypertensive nephropathy, peripheral artery lesion. Sixty (15,2%) untreated patients with Stage 1 HD without clinical signs of organ changes were recorded among the same cohort in Substudy 2. In both substudies, Group 1 received a fixed-dose combination of eprosartan mesylate 600 mg once daily and hydrochlorothiazide 12,5 once daily regardless of baseline BP at the onset of the study. Group 2 had monotherapy with enalapril and/or its combination with hydrochlorothiazide depending on the degree of BP elevation and the group of a cardiovascular risk. Results. Starting fixed-dose combination antihypertensive therapy (eprosartan + hydrochlorothiazide) irrespective of baseline BP and cardiovascular risk versus monotherapy with enalapril and/or its free combination with hydrochlorothiazide, which was used in terms of BP level and cardiovascular risk ensured a more significant regression of both clinical and subclinical target organ damages during 6-month therapy according to the changes in left ventricular mass (LVM), LVM index, and tissue inhibitor of type 1 matrix metalloproteinases, microalbuminuria and glomerular filtration rate, intima-media complex thickness during carotid Doppler ultrasound study, and pulse wave velocity in different segments, as evidenced by volumetric sphygmoplethysmography. Conclusions. The use of a fixed-dose combination of eprosartan and hydrochlorothiazide in untreated patients of able-bodied age regardless of baseline BP and cardiovascular risk ensures the regression of target organ damages and the prevention of their development in the absence of organ changes.
Comparative characterizations of patients with hypertensive disease in the mid-1980s and in the 2010s (the patients’ portraits in the context of factor analysis)
Authors: Zakharova E G , Fursov A N , Potekhin N P
Published: February 2021

Aim: to study the clinical characteristics of patients with hypertensive disease (HD) in the first decade of the 21st century versus the mid-1980s, by using multivariate statistical methods for the further optimization of therapeutic and diagnostic guidelines. Materials and methods. 234 case histories of patients with HD in the periods 1985 to 1987 (Group 1) and 2010–2012 (Group 2) were analyzed. Factor analysis of 110 signs identified 7 factors or leading symptom complexes. Results. Comparison of HD patients’ portraits in the mid-1980s and the first decade of the 21st century may lead to a number of main conclusions: firstly, HD has undergone certain alternations in the past quarter of a century, which is associated with changes in both the socioeconomic characteristics of society and those in approaches to therapy and with the advent of novel groups of antihypertensive drugs; secondly, the emergence of drugs with a proven nephroprotective effect (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers) resulted in the reduced negative impact of BP on renal functions. Thus, three of the seven factors in Group 1 are directly related to the renal function of patients with HD while Group 2 shows only one factor of systemic and intraglomerular hypertension; thirdly, metabolic disturbances assume great importance in the characterization of Group 2 patients. Metabolic syndrome is typical of them; fourthly, for the patients of the early 21st century, of particular significance is tobacco smoking that is not only a risk factor of cardiovascular diseases in general, but also a factor influencing of the diurnal BP variation that promotes the formation of its particularly unfavorable variants – a night peaker, and finally fifthly, the patients of the early 21st century are characterized by a greater adherence to systemic antihypertensive therapy, which positively affects primarily on the course of the disease, by preventing target organ damage. Conclusion. The findings make it possible to optimize therapeutic and diagnostic efforts in patients with HD and to make more goal-oriented secondary prevention of complications.
Real and potential benefits of third-generation calcium antagonists
Authors: Kirichenko A A
Published: February 2021

The paper considers the specific features of the pharmacokinetics of third-generation dihydropyridines (membrane-controlled pharmacokinetics). Comparative trials have shown their longer action and high efficacy, which are highly competitive with those of major groups of antihypertensive drugs. Lercanidipine proved to have the nephroprotective activity comparable with that of angiotensin-converting enzyme (ACE) inhibitors. They have been demonstrated to have a better tolerance and safety than second-generation calcium antagonists.
The 2012 hypertension summer school in Dublin (Ireland)
Authors: Blinova N V , Elfimova E M
Published: February 2021

Annual Hypertension Summer School 2012, organized by the European Society of Hypertension, was held in Dublin (Ireland). The following topics on epidemiology, pathophysiology, diagnostics and treatment of arterial hypertension were covered during the school. Particular attention was given to the target organ damage, as well as to the peculiarities of management and treatment of arterial hypertension in various groups of patients.
Priorities for choosing diuretics in the treatment of hypertensive disease: Evidence-based medicine, recommendation documents, and real clinical practice
Authors: Kompaniets O G , Averin E E
Published: February 2021

Reorganization of the drug supply is one of the most important parts of the Russian health care reform. Pharmacoepidemiology is one of the sections of clinical pharmacology, the study of the results of the application and effects of drugs in large groups. The aim of the study was the analysis of pharmacoepidemiological and validity purpose diuretic therapy in patients with hypertension and chronic heart failure in clinical practice. A comparative analysis of retrospective pharmacoepidemiological diuretic in the hospital according to the sources of primary medical records for 2010-2012. - Continuous sampling histories hospital regional center and district hospitals in Krasnodar Krai (435 patients). The results of our study showed an active and relevant guidance documents use of diuretics doctors practical medicine. There have been no use of diuretics is the testimony and in the presence of contraindications, revealed no excess doses and irrational combinations. Can be considered a positive increase in the activity of torasemide destination due to the impact of the drug on the prognosis of the disease, which can be realized through antialdosterone effect and influence on depozitsiyu collagen. Analysis of contemporary domestic and foreign recommendations GB and CHF, as well as evidence-based data suggests that the use of diuretics is a stable long-term trends in the pharmacotherapy of cardiac disease, so you need to continue to assess the quality of the clinical use of pharmacological agents, to raise awareness doctors about clinical situations with the need to connect with spironolactone and acetazolamide, as well as a new indication and especially the appointment of torasemide in patients with chronic heart failure, hypertension, as reflected in clinical guidelines and "standards of primary health care workers in essential hypertension (hypertension) "Health Ministry.
Effect of adrenalectomy on the condition of the myocardium and arteries in hypertensive patient with primary hyperaldosteronism
Authors: Valieva Z S , Chikhladze N M , Sakhnova T A , Blinova E V , Panteleev I V , Tripoten M I , Balakhonova T V , Chazova I E
Published: February 2021

In the last years several studies demonstrated the important role of aldosterone not only in the development of arterial hypertension bur also in the development of cardiovascular complications. Growing investigations have recognized the important role of aldosterone in the development of left ventricular hypertrophy, the myocardial fibrosis and changes in the wall of the carotid arteries. This article provides a clinical case of hypertensive patient with primary hyperaldosteronism. The dynamics of blood pressure, the state of Renin-Angiotensin-Aldosterone System, left ventricular myocardium and carotid arteries were analized in the preoperative period, and in one year follow-up after the successful removal of the aldosteroma
Effect of the fixed-dose combination Ekvator on blood pressure level and cognitive functions in elderly patients with arterial hypertension
Authors: Ostroumova O D , Pervichko E I
Published: February 2021

The paper gives the data of the authors’ trial of the effect of the fixed-dose combination antihypertensive drug lisinopril + amlodipine on blood pressure level and cognitive functions in 25 elderly patients with grades 1–2 arterial hypertension. The test drug has a high antihypertensive efficacy, as shown by both routine blood pressure measurements and 24-hour monitoring data. The findings suggest that the fixed-dose combination antihypertensive drug lisinopril + amlodipine improves a number of parameters characterizing cognitive functions
Sartans in the treatment of high-risk hypertension: the abilities of candesartan
Authors: Morozova T E
Published: February 2021

This paper presents an overview of the literature on the treatment of arterial hypertension drugs that block the renin-angiotensin-aldosterone system (RAAS) – angiotensin receptor blockers ΙΙ (ARB), whose action is based on inhibition of the RAAS at the AII receptor. ARB candesartan (atakand), along with a strong long-term antihypertensive effect has organoprotective (causes regression of LVH has nephroprotection) antidiabetogennym effect, prevents the development of stroke. Clinical experience suggests candesartan, high efficiency and a good range of security among different categories of hypertensive patients with concomitant pathology, chronic heart failure, diabetes, obesity.
Factors influencing compliance with lifestyle modification in an organized population
Authors: Alekseeva Tat'yana Sergeevna , Ogarkov Mikhail Yur'evich , Skripchenko Alla Evgen'evna , Yankin Maksim Yur'evich
Published: February 2021

Objective: to identify the factors influencing compliance with lifestyle modification for the primary and secondary prevention of arterial hypertension (AH) in an organized population. Subjects and methods. The investigation enrolled 435 subjects (339 men and 96 women). The mean age of shop workers was 43 (range 33 to 49) years. The investigation program consisted of filling out a questionnaire containing sociodemographic characteristics, anthropometric data, information on the presence of bad habits and AH. Blood pressure, total blood cholesterol, and cardiovascular risk were determined in all the subjects included in the investigation. After examination, they were all recommended to observe healthy lifestyle and to modify risk factors, if any. The investigators implemented systematic prophylactic measures. Interim assessments of results were made during annual prophylactic examinations. Results. Education and age were factors that influence compliance with lifestyle modification. Compliance was found to increase with age. Assessment of the importance of education level for compliance with medications to prevent AH demonstrated that the subjects with lower (secondary) education were less compliant. At the same time, our investigation revealed no significant impact of an occupational factor on compliance. There was simultaneously a trend suggesting that the women were more compliant with nondrug therapy; however, the differences failed to achieve the level of statistical significance. Conclusion. Education and age were factors that influence compliance with lifestyle modification. At the same time, our investigation did not reveal any gender differences or any significant influence of an occupational factor on compliance.
Use of diuretics in hypertensive patients with metabolic disturbances
Authors: Zhernakova Yuliya Valer'evna , Chazova Irina Evgen'evna
Published: February 2021

The multicenter research MERSY (Moxonidine Efficacy on blood pressure Reduction revealed in a metabolic SYndrome population) finished in 2008 was devoted to an assessment of long-term safety and efficiency of agonist I2-imidazolin receptors – moxonidine in patients with arterial hypertension and metabolic syndrome (in the general group and in advance defined subgroup of patients in a postmenopause). In 2013 final international results of the research MERSY which showed high antihypertensive activity of moxonidine, and also its positive influence on metabolic parameters and mass of a body were published.
Efficacy of irbesartan in arterial hypertension and metabolic syndrome
Authors: Ostroumova O D , Zykova A A , Polosova T A , Bondarets O V
Published: February 2021

The paper gives the data of Russian guidelines for the diagnosis and approaches to treating metabolic syndrome. It considers the choice of antihypertensive drugs in the treatment of hypertensive patients with metabolic syndrome. The benefits of angiotensin II receptor blockers are shown. The results of a number of trials evaluating the efficacy and safety of irbesartan used to manage arterial hypertension in metabolic syndrome are analyzed.
Legochnaya arterial'naya gipertenziya: na puti ot ratsional'noy diagnostiki k vyboru effektivnoy lekarstvennoy terapii
Authors: Chazova I E , Martynyuk T V
Published: February 2021

Pulmonary arterial hypertension (PAH) is a clinical condition characterized by precapillary pulmonary hypertension (PH) in the absence of other causes leading to an increase of blood pressure in the pulmonary artery (PA), such as lung diseases, chronic PA thromboembolism, etc., including rare diseases. The Fourth World Symposium on PH in 2008 proposed new diagnostic criteria for PAH: a resting mean PA pressure ≥25 mm Hg with a normal PA wedge pressure ≤15 mmHg. PAH is the first category of PH involving different nosological entities with similar clinical manifestations, morphological patterns, and hemodynamic disorders. The key component in the pathogenesis of PAH is endothelial dysfunction with imbalance between vasodilators and vasoconstrictors and activation of the blood coagulation system, giving rise to pulmonary vascular remodeling and enhanced pulmonary vascular resistance. The detection of potential targets for therapeutic exposure and a considerable number of randomized trials using the pathogenic therapeutic agents led to the introduction of medicines that affect three potential targets: 1) deficiency of prostacyclin that replenishes its analogues (prostanoids); 2) that of nitric oxide, the vasodilator effect of which is associated with the elevated level of cyclic guanosine monophosphate, which substantially improved treatment possibilities in patients with PAH. The PACES trial of the efficacy of sildenafil in combination with intravenous epoprostenol is an example of effective specific combination therapy for PAH.
Modern approaches to combined therapy of arterial hypertension
Authors: Napalkov D A , Zhilenko A V
Published: February 2021

The article discusses some of the changes in the 2013 European Guidelines in comparison with the previous revision with an emphasis on practical activities of cardiologists and therapists as well as the combined therapy of high blood pressure. Also, special attention is paid to one of the preferred combinations of antihypertensives – a combination of ACE inhibitor and calcium antagonist and, in particular perindopril and amlodipine.
The comparative analysis of therapy by «typical practice» and the fixed combination perindopril and indapamide an arterial hypertension with kidney insufficiency
Authors: Shiganov S V , Baev V V , Shulbayev A P
Published: February 2021

Results of the conducted prospektivny clinical research devoted to a comparative assessment of hypotensive and nefroprotektivny efficiency of the fixed combination perindopril and indapamid in comparison with by «typical practice» treatments of an arterial hypertension with kidney insufficiency on the frequency of achievement and maintenance of level of target arterial pressure, dynamics of a system glomerular filtration of a formula to the Cockcroft-Gault.
Clinico-pharmacological aspects of metoprolol use
Authors: Anikin G S , Chernova I M , Vinokurov V G
Published: February 2021

Over the years b-blocker metoprolol is one of the commonly prescribed drugs for the treatment of various cardiovascular pathologies . The following review article discusses the classification of b-blockers , and pharmacokinetics of two metoprolol forms available on the market today: metoprolol tartrate (Vasocardin, Corvitolum, Egilok ) and metoprolol succinate (Betaloc ZOK). The role of metoprolol in the treatment of hypertension, coronary artery disease and heart failure is described here as well.
Hypertension treatment features in perimenopausal women
Authors: Zhernakova Yu V , Chazova I E
Published: February 2021

Major causes of disability among women are chronic heart failure, developed on arterial hypertension (AH) and cerebral stroke. However, the prevalence of AH among postmenopausal women is significantly higher than for men. Women are more likely to develop AH with metabolic disorders, including metabolic syndrome. Therefore, the drugs of choice to treat AH in women in perimenopauseare ACE inhibitors and Angiotensin II Receptor Blocker. If necessary, combination antihypertensive treatment drugs of choice are agonistsimidazoline receptors, such as moxonidine. The use of this category of patients havemoxonidine action justified by the features of the pharmacological action of this drug (decrease in sympathetic hyperactivity), high efficiency, antihypertensive as well as additional positive effects on body weight and metabolic parameters.
Candesartan in treating hypertension
Authors: Minushkina L O
Published: February 2021

Candesartan is a selective angiotensin II receptor blocker type 1. The distinctive features of its pharmacokinetics and pharmacodynamics are long duration of antihypertensive action, high selectivity and good bioavailability. In the treatment of hypertension, candesartan can effectively prevent morning rise in blood pressure. For preparation peculiar cerebro-and cardioprotective effects, the ability to reduce the risk of new cases of diabetes. The drug is effective in the treatment of nephropathy different genesis, including in patients with a marked reduction in renal function. Metabolic neutrality, the ability to prevent the development of micro-and macroangiopathy can recommend this angiotensin receptor blocker in the treatment of diabetic patients. Favorable profile of the pharmacokinetic properties of an advantage in efficacy of candesartan in comparison with other drugs of the same group.
Rational therapy of hypertension with concomitant ischemic heart disease
Authors: Chukaeva I I , Orlova N V , Soloveva M V
Published: February 2021

Hypertension is one of the most common cardiovascular diseases, that causes the disability and mortality. Recommendations of the European Society of Hypertension and the European Society of Cardiologyin 2013 identified new approaches of antihypertensive therapy. For the control of blood pressure is recommended five major groups of drugs. Numerous multicenter studies confirm the high efficiency of angiotensin converting enzyme inhibitors (perindopril) and calcium antagonists (amlodipine). Drugs have proven marked hypotensive and cardioprotective effects. Prestarium fixed combination with a calcium antagonist such as amlodipine (Prestancia) due to the synergistic effect allows for greater efficiency and can be recommended in the treatment of combined pathology of hypertension and coronary heart disease.
Risk of target organ damage in patients with arterial hypertension and various numbers of metabolic syndrome components
Authors: Zhernakova Yu V , Sharipova G Kh , Chazova I E
Published: February 2021

The metabolic syndrome is one of most socially significant and strategic problems of clinical medicine. It is known that metabolic syndrome promotes earlier and more expressed target organ damage in patients with arterial hypertension. However, correlation of the number of metabolic syndrome components with target organ damage, selection of metabolic syndrome components, influencing expressiveness on target organ damage, are studied insufficiently. In this study it is determined that with the elevating number of the metabolic syndrome components, the frequency and expressiveness of heart, kidney and vessel damage, accompanied by the increased risk of development of cardiovascular complications, increase in patients with the maximum number of the metabolic syndrome components. Moreover, it is revealed that the relative risk of simultaneous damage of heart, kidneys and vessels in patients with arterial hypertension and metabolic syndrome, apart from high blood pressure and abdominal obesity is associated with the increase of fasting glucose level.
National questionnaire of treatment compliance:testing and application in outpatient practice
Authors: Fofanova T V , Ageev F T , Smirnova M D , Svirida O N , Kuzmina A E , Thostov A Sh , Nelyubina A S
Published: February 2021

Objective. The aim is to test national questionnaire of treatment compliance of patients with arterial hypertension in the outpatient setting. Materials and methods. The study enrolled 60 patients with stages 1 and 2 arterial hypertension at the age of 45-75 years. We made general clinical examination, measurement of office blood pressure (BP) and biochemical blood assay, run questionnaire survey (hospital anxiety and depression scale (HADS), Morisky-Green test (4-item Medication Adherence Report Scale - MARS), national questionnaire of treatment compliance, assessment of quality of life using Visual Analogue Scale (VAS), calculated the number of pills taken by the patient, issuance and the analysis of returned diaries for self-monitoring. Total sampling was accounted for 43 patients.Results. National enquirer demonstrates statistically significant correlation of results compared to the results of treatment compliance, using Morisky-Green test, and compared to the index commitment based on the total number of pills taken by the patient from the blisters which had been prescribed by the doctor.
Β-blockers: the lack of taskimplementation or the unwillingness of doctors in the russian federation to optimize the treatment?
Authors: Fomin I V , Polyakov D S
Published: February 2021

The purpose of the study. The achievedheart rate of 50-60 beats per minute in patients after acute myocardial infarction, and up to50-70 beats per minute for patients with stable angina is considered effective. Assuming that in Russia low doses of β-blockers are often used, thequestion was raised: «How common tachycardia can bein patients with coronary heart disease (CHD) and chronic heart failure (CHF), and whether there are strategic approaches to achieving the targets in heart rate in these patients in real clinical practice and are β-blockers often used in patients for whom this group of drugs is the basic one?»Materials and Methods. Work carried out in the framework of the Russian epidemiological study of a representative sample of the European partof the Russian Federation. All patients with CHF and coronary artery disease were divided into two subgroups: heart rate reducers not receiving medicines and receiving at least one heart rate reducing drug (a β-blocker, calcium channel 1 and 3rd type (AK) blockers, glycosides).Results and discussion. In a representative sample of the program in healthy individuals (without clinical manifestations of coronary arterydisease) tachycardia was diagnosed in 7,1% of cases. Almost all respondents without CHD (87,3%) had normal heart rate from 61 to 80 beats per minute. Number of respondents without CHD with heart rate of 70 to 79 bpm. per min. (54,1%) turned out to be significantly less than that of patients with rhythm in any form of coronary artery disease (p
Efficacy and safety of amlodipine and perindopril (Prestance) fixed combination in patients with arterial hypertension during the summer heat
Authors: Chazova I E , Ageev F T , Smirnova M D , Ageeva N V , Fofanova T V , Svirida O N , Mikhailov G V , Levin A M , Revich B A
Published: February 2021

Relevance. Impact of the drugs on adaptation to the heat wave of abnormal temperature has been one of the most important practical medicine questions in recent years. One of the points at issue is safety calcium channel antagonists and ACE inhibitors treatment during abnormal heat. The aim of the study is to investigate the efficacy and safety of perindopril arginine (drug Prestance - Servier Industries, Ltd.) and amlodipine fixed combination in arterial hypertension (AH) patients during the summer heat and the summer heat influence on the adaptation mechanisms to abnormally high temperatures.Materials and methods. The study enrolled 165 patients with stages 1 and 2 AH: 69 patients with average risk and 91 patients with high andvery-highrisk 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, biochemical blood assay and hematocrit and were running questionnaire survey: visual analogue scale (VAS), Morisky-Green test and questionnaire for the patients who were exposed to heat. Pulse ware velocity was measured in 30 patients. The first visit was done in the first half of June 2013, the second visit - during the heat (July 2013), the third one in September 2013. Results. In the course of the study systolic (SBP) and diastolic BP (DBP) were reduced (р
Effects of loop diureticswith differenthalf-elimination times on natriuresis changes in hypertensive patients with different blood pressure profile
Authors: Arutyunov G P , Dragunov D O , Sokolova A V
Published: February 2021

The aim is to study the interaction of natriuresis curves with 24-h blood pressure (BP) profile, as well as to study the effect of diuretic therapy on natriuresis changes and on the BP profile.Materials and methods. From the group of patients who participated in the study on the types of natriuretic curves we selected patients (n=56) with signs of deterioration of chronic heart failure (CHF) and who should be prescribed diuretic therapy. Patients received torasemide SR or IR. Results. It was demonstrated that type of natriuresis curves and blood pressure (BP) profile could be changed. Deterioration of natriuresis more oftener and earlier were observed in torasemide IR group compared with torasemide SR group of patients (p