bluuebunny/crossref_metadata_2025 huggingface dataset:
Heart rate variability and professional stress severity in young people with initial symptoms of arterial hypertension at dynamic physical exertion
Authors: Zhidkikh B. D. , Shvetс E. V.
Published: December 2018

Relevance. Influence of psychological stress on individuals can be assessed by heart rate variability (HRV) analysis. The syndrome of mental "burning out" often reflects psychological stress in physicians. Aim. The study addresses relation between HRV and the severity of professional stress among medical students with initial symptoms of arterial hypertension under dynamic physical exertion. Material and methods: 98 people took part in our research: 50 students of first years, 20 of which tended to have high blood pressure (BP), and 48 doctors-interns. Professional stress was diagnosed by V.V. Boyko's technique. BP by Korotkov's method and HRV analysis of the electrocardiogram (using Cardiotechnique-04) were taken while veloergometry at 100 Vt was performed. Results. 90 % of students are under I phase of stress strain that is accompanied by the increase of diastolic BP (р < 0,05). Out of studied hemodynamic parameters (systolic and diastolic BP, heart rate) only systolic BP was found to decrease till 124,6 ± 4,58 mmHg (p < 0,05) in 32,5 % of subjects under II phase of stress having got 5-minute rest after physical exertion. Sympathetic nervous system activity assessed by the decrease of HRV parameters and LF/HF-ratio increase was prevalent in the same group.
Adenos ine diphosphate-induced platelet aggregation in patients with coronary artery disease and concomitant anxiety and depression
Authors: Kozlova S. , Golubev A. V. , Krylova U. S. , Efimova I. Y. , Shlyakhto E. V. , Neznanov N. G. , Kadinskaya M. I.
Published: December 2018

We studied the changes in adenosine diphosphate (ADP)-induced platelet aggregation in patients with coronary artery disease (CAD) and concomitant anxiety and depression. We found a significant reduction of platelet aggregation response (time of aggregation at ADP concentration 1,25 and 2,5 µM, maximum percentages of aggregation at ADP concentrarion 1,25 µM) in plasma of patients with CAD and concomitant anxiety and depression as compared with patients with CAD without anxiety and depression. Our results do not support hypothesis of an increased thrombosis in patients with CAD and anxiety and depression.
Predictors of recurrent myocardial ischemia in patients with non-ST elevation acute coronary syndrome following coronary artery bypass grafting surgery
Authors: Korzhenevskaya K. , Kozlov P. S. , Kozlov V. V. , Abesadze I. T. , Alugishvili M. Z. , Lokhovinina N. L. , Usova E. A. , Panov A. V.
Published: December 2018

The short- and long-term outcome of coronary artery bypass grafting surgery (CABG) in 130 patients with non-ST elevation acute coronary syndrome (NEST ACS) is presented. 73,1 % of patients had the benefi cial CABG effect towards the end of 48-month follow-up. We observed increasing recurrent angina rate with time after CABG. The recurrent myocardial ischemia after urgent CABG is associated with younger age, severe angina in past, off-pump CABG performing and keep on smoking after myocardial revascularization.
The diagnostic method of diabetic cardiomyopathy
Authors: Yakusheva M. U. , Sarapultsev A. P. , Dmitriev A. N. , Sarapultsev P. A. , Trelskaya N. U.
Published: December 2018

The purpose of the work was the development of a technique of defi nition screening markers of genetic predisposition to the development of diabetic cardiomyopathy. Research problems: revealing morphological signs of diabetic cardiomyopathy at patients with type 2 diabetes on the basis of the echocardiography data; an establishment of screening dermatoglifi c criteria of diabetic cardiomyopathy. The research group included 68 patients with type 2 diabetes, the control group included almost healthy 68 people. The signs of diabetic cardiomyopathy were observed in all patients with type 2 diabetes and included the changes of structural and functional indicators of heart, hypertrophy of heart chambers, and the presence of diastolic dysfunction. The prominent features of dermatoglifi c picture were revealed in patients with type 2 diabetes, that testifi es the participation of the genetic factor in formation of predisposition to this kind of pathology. The offered biometric technique can be used for revealing people with the increased risk of diabetic cardiomyopathy development.
Adhesion endothelial dysfunction and immune inflammatory factors in hypertensive patients with coronary heart disease: effects of rosuvastatin
Authors: Krasilnikova E. I. , Nifontov E. , Sergeeva E. G. , Antono-Va T. V. , Zhloba A. A. , Galkina O. V. , Romanova M. A.
Published: December 2018

Modern views on atherosclerosis pathogenesis are briefly summarized regarding the role of vascular cell adhesion molecule-1, homocysteine and asymmetric dimethylarginine as risk factors for endothelial dysfunction and atherosclerosis onset and progression. Rosuvastatin (Crestor, AstraZeneca, Great Britain) efficiency data according to multicenter clinical trials are presented as well as the results of the own study on Crestor impact on immunological factors of endothelial lesion in hypertensive patients with coronary heart disease.
Hypertension in the Chechen Republic: social aspects of the problem
Authors: Yusupova M.
Published: December 2018

The article presents the results of the sociological analysis performed in hypertensive patients living in the Chechen
Republic. Economical status and education level are the main factors infl uencing health self-appraisal, emotional condition
and psychological environment in the family of hypertensive patients. The low level of medical activity and the absence of
the elementary preventive measures such as regularly blood pressure control independent of economical status and education
level are remarkable. The medical activity is higher but health self-appraisal is lower in patients who have relatives with
cardiovascular pathology. The lonely patients have worse rates of health state. Revealed features can be useful in planning
of prevention programs to reduce risk of different vascular complications in these patients.
Echocardiography criteria of blood turbulence in the left ventricle during diastole in children
Authors: Priima N. F. , Ivanov D. O. , Bure N. P. , Popov V. V.
Published: December 2018

Objective. To study the hemodynamics in left ventricle (LV) cavity of the left ventricle by Doppler method. Design and methods. 50 children (20 female, 30 male) including 15 athletes (aged from 5 days to 18 years old) were examined. Ultrasonic scanner «SonoACE-9900» was used. Results. The wave with biphasic amplitude on peak E of transmural blood stream (named «Sh»-wave) was registered when the «control volume» was placed in LV cavity, and its velocity characteristics and duration of positive and negative phases were determined. Children with average heart rate 95,4 ± 5,2 b/min. «Sh»-wave duration was 39,4 ± 10,6 msec, and velocity characteristics of positive and negative phases were 75,4 ± 9,4 and 41,3 ± 6,5 cm/sec. respectively. Athletes with sinusal bradycardia (average heart rate 58,7 ± 2,3 b/min.) had longer «Sh»- waves (66,1 ± 15,2 msec), higher velocity characteristics of positive phase (78,8 ± 11,3 cm/sec.) and lower velocity of negative phase (32,6 ± 5,3 cm/sec.). Conclusion. The spherical turbulent blood stream in the LV can be formed during diastolic filling. It presents as an echo-signal of biphase amplitude in the middle third of LV.
Underweight and overweight: between Scylla and Charybdis
Authors: Drapkina O. M. , Dikur O. N.
Published: December 2018

It is well known that overweight as well as underweight is strongly associated with increased risk of development of many disorders, particularly cardiovascular pathology. The paper discloses the most appreciable problems of health associated with obesity and underweight. Pathophysiological mechanisms of development of the basic metabolic disturbances underlying obesity and diabetes mellitus, such as insulin resistance and dyslipoproteinemia, are described. The interaction of hereditary and environmental factors leading to adiposity is discussed in the light of the novel theories of development of adiposity, such as the hypothesis of a thrifty phenotype and "the selfish brain theory". Particular cases of obesity development in the absence of insulin resistance are described. The clinical phenomenon of paradoxical more favorable prognosis in patients with overweight in comparison with patients with normal weight and underweight (the obesity paradox) is discussed.
Clinical features of cardiomiopathies caused by cardiac troponin I mutations (review)
Authors: Youschenko M. V. , Shlyakhto E. V. , Novik G. A. , Kostareva A. A. , Gudkova A. Ya.
Published: December 2018

Clinical and genetic aspects of cardiomyopathies caused by cardiac troponin I mutations are observed. Apparent clinical heterogeneity with development of both hypertrophic and restrictive phenotypes and high risk of sudden death are presented.
Mono- and combined therapy of low-renin hypertension by original enalapril (Renitec) and its effects on renin-angiotensin-aldosteronе system
Authors: Akhadov Sh. V. , Ruzbanova G. R.
Published: December 2018

Objective. To estimate efficiency of original enalapril Renitec in patients with low-renin hypertension (NR АH). Design and methods. 202 patients with NR АH were recruited. The mean systolic blood pressure (BP) was 196,6 ± 6,2 mmHg, diastolic BP - 112,4 ± 5,6 mmHg . Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were estimated by radio-immune method in active patients. PRA was rated as normal if ranged 1,0-3,0 ng/ml/h, PA - 0,18-0,83 nmol/l (5-23 ng/dl or 50-230 pg/ml). Normal PA/PRA ratio was 5-23. Conclusion. 1) Nonstimulation renin criterion in the test with 20 mg/day enalapril (Renitec) intake is the impossibility of PRA increase more than 1,0 ng/ml/h, and angiotensindependent BP criterion is the decrease of PAC and/or PAC:PRA more than 20 % from the baseline level. 2) The primary task of NR АH treatment is the normalization of indicators of rennin-angitensin-aldosterone system and the achieving of target BP. Treatment should be started with monotherapy 20 mg/day enalapril (Renitec) intake. If PAC: PRA is normal but BP is still elevated a calcium blocker should be added. If PAC:PRA is abnormal after enalapril monotherapy then a low daily dose of spironalactone is added.
Clinical case report Paroxismal hypertension or pseudopheochromocytoma
Authors: Vitkovskaya E. V. , Bogomolova O. V. , Konradi A. O. , Shlyakhto E. V.
Published: December 2018

Представлен разбор клинического случая пациентки с пароксизмальным, кризовым, течением артериальной гипертензии, резистентной к стандартной антигипертензивной терапии. Рассматриваются подходы к диагностике и лечению пароксизмальной гипертензии, отличительные клинические особенности псевдофеохромоцитомы.
Effect of enalapril (Reniteс) on the renin-angiotensin-aldosterone and sympathoadrenal system in hypertensive patients
Authors: Akhadov Sh. V. , Ruzbanova G. R. , Akhadova A. Sh.
Published: December 2018

Objective. To study the infl uence of enalapril 20 mg/day on the sympathoadrenal (SAS) and renin-angiotensinaldosterone systems (RAAS). Design and methods. 149 subjects (102 patients with essential arterial hypertension (EAH) and 47 patients with primary hyperaldosteronism, PHA) were included. Mean systolic blood pressure (BP) (M  m) was 194,6  7,4 mmHg, diastolic BP - 116, 2  5,4 mmHg. Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were estimated by radio-immune method in active patients. PRA was rated as normal if ranged 1,0-3,0 ng/ml/h, PAC - 0,18-0,83 nmol/l (5-23 ng/dl or 50-230 pg/ml). Normal PAC/PRA ratio was 5-23. The daily urine excretion of adrenaline (normal - 18-33 mmol/l) and noradrenaline (normal - 150-256 mmol/l) were determined by fl uorometric method. Conclusions. 1) Effects of angiotensin-converting enzyme (ACE) inhibitors on the synthesis of aldosterone and catecholamines in EAH patients are associated with the changes of circulating angiotensin II concentration, and in PHA patients - with the decrease of tissue angiotensin II concentration in cortical layers of the adrenal gland and central nervous system. 2) Reactive increase PRA in EAH patients treated with enalapril is rather related to the blockade of renal tissue angiotensin-converting enzyme than to the circulating angiotensin II. 3) PHA patients are characterized by the phenomenon of up regulation of aldosterone receptors and of tissue renin-angiotensin system that is defi ned by optimum reduction of PAC, the lack of normalization of PRA and blood pressure in response to the application of enalapril 20 mg/day.
The role of nonesterified fatty acids in pathogenesis of cardiovascular diseases
Authors: Tsvetkova M. V. , Khirmanov V. N. , Zybina N. N.
Published: December 2018

The paper reviews publications concerned the role of nonesterifi ed fatty acids (NEFA) in pathogenesis of cardiovascular diseases. NEFAs are four and more carbons chain length carbonic acids and they are presented in free form (nonesterifi ed) in human body. Plasma NEFAs are produced by the adipose tissue triglyceride lipolysis, another source are lipoproteins such as chylomicrons, very low density lipoproteins and intermediate density lipoproteins. Elevated NEFA concentrations in plasma are the risk factor of cardiovascular diseases and type 2 diabetes mellitus and the independent risk factor of hypertension and sudden death. NEFA plasma concentration is elevated in atherosclerosis, acute myocardial infarction, diabetes mellitus, obesity, hypertension, and often in metabolic syndrome. A probable cause of NEFAs accumulation in plasma may be overeating and low physical activity, which result in increase of adipose tissue mass, lipolysis intensifi cation and elevation of NEFAs concentration in plasma. The role of elevated plasma NEFA concentration in a number of conditions (abdominal obesity, atherogenic dyslipidemia, insulin resistance, type 2 diabetes mellitus, endothelial dysfunction, vascular infl ammation, atherosclerosis, hypertension, ischemic heart disease, rhythm disturbances, sudden death) and possible ways of their correction are discussed.
Blood pressure profile, structural and functional cardiac parameters, renal function and metabolic status in hypertensive patients with chronic secondary pyelonephritis
Authors: Statsenko M. E. , Derevjanchenko M. V.
Published: December 2018

Objective. To study the blood pressure variability, morphofunctional parameters of the heart, kidney and metabolic status in hypertensive patients with secondary chronic pyelonephritis. Design and methods. The study included 110 patients: 55 patients with arterial hypertension and secondary chronic pyelonephritis, who underwent surgery for upper urinary tract, and 55 patients with essential arterial hypertension. All patients underwent 24-hour blood pressure monitoring, echocardiography; relative urine density in the morning urine portion, microalbuminuria, blood creatinine were assessed, glomerular fi ltration rate was calculated using MDRD formula. Results. Patients with arterial hypertension and chronic pyelonephritis have signifi cant changes of the blood pressure profi le, and hypertrophy and diastolic left ventricle dysfunction are more frequently observed in this group. A close relation between renal function and the state of the cardiovascular system is established. We also found higher numbers of total cholesterol, the most atherogenic fractions of cholesterol and triglycerides in this group compared to patients with essential hypertension.
Early Doppler features of structural and functional changes of renal arteries in patients with essential hypertension
Authors: Melnikova L. V. , Bartosh L. F.
Published: December 2018

Objective. To assess the intrarenal blood fl ow in hypertensive patients at orthostatic test. 79 subjects (36 males and 43 females) with arterial hypertension of II stage were enrolled. The renal blood fl ow was investigated using Doppler study with the spectral analysis at level of interlobar arteries. The direct relation between pulsatility index and pulse pressure was found (r = 0,52; p = 0,0001). Peripheral resistance and vascular rigidity were higher in patients with increased blood fl ow acceleration time in interlobar arteries at orthostatic test. Thus, Doppler study of intraparenchymal blood fl ow at orthostatic test can be used for early diagnosis of structural and functional changes of renal arteries.
Effectiveness of different educational models in elderly hypertensive patients with heart failure
Authors: Simerzin V. V. , Garkina S. V.
Published: December 2018

Design and methods. We observed 64 geriatric patients (67,3  3,9 years old) with chronic heart failure (CHF) and arterial hypertension (AH), which had been divided into 2 groups. The fi rst group included 32 patients who received classical group educational model, the second - 32 patients who were individually educated based on effective medical consulting. All patients received standard treatment of AH and CHF (angiotensin-converting enzyme inhibitors, -blockers, diuretics, aldosterone antagonists and digoxin). Results. Initially less than 14 % of patients had good compliance. After 12 months of intervention, medication adherence increased to 59,4 % in I group and 87,5 % in II group. In 6 months the dynamics of clinical symptoms and functional status was positive in all groups, particularly after individual education, the difference between groups was signifi cant in 12 months. Only in II group we observed signifi cant reduction of emergency calls and extra hospital admissions due to decompensation of CHF. Conclusion. The complex approach to education of elderly patients is effective and has economic benefi ts.
Assessment of the relationship between N-terminal pro-BNP levels and ambulatory blood pressure monitoring data in hypertensive patients
Authors: Kostoeva A. U. , Pshenytsyn A. I. , Zolozova E. A. , Chiginyova V. V. , Sbrodova L. V. , Volkov V. E. , Babaev F. Z. , Hezheva F. M. , Mazour N. A.
Published: December 2018

Objective. To study the association between N-terminal pro-brain natriuretic peptide (N-proBNP) and diurnal blood pressure profi le in hypertensive patients. Methods and results. A total of 40 patients were included in the study. Peptide concentration increased with age, correlated positively with diurnal pulse blood pressure variability and its mean cumulative value over night period in hypertensive patients. In patients with high plasma concentrations of peptide its level positively correlates with pulse blood pressure value and its variability and mean cumulative value over day period. In this subgroup signifi cant positive correlation between N-proBNP levels and systolic blood pressure over day period was found.
Masked hypertension in young patients
Authors: Bubnova V. S. , Shaposhnik I. I.
Published: December 2018

Objective. To study the benefits of 24-hour blood pressure monitoring (ABPM) for diagnosing «masked» arterial hypertension (AH) in young men and characteristics of the blood pressure daily profile in this group. Design and methods. 224 men were examined; Among them 100 men were aged 18-30 years, mean age was 23,6 [22,8-24,3] years. Clinical study and instrumental (ABPM) examination were performed. Results and conclusions. It is reasonable to use ABPM as obligatory method to diagnose «masked» AH in young subjects, since in 1/3 cases ABPM data confirm AH when office BP is normal. Main types of alteration of night BP decrease included «over-dipper» (16,0 %) and «non-dipper» (33,0 %) types in young subjects, while «non-dipper» type was predominant (48,4 %) in middle-aged group.
Genetic markers of antihypertensive drug efficacy
Authors: Khasanov N. R.
Published: December 2018

Objective. To assess the antihypertensive efficacy of monotherapy with Nifedipine Retard, Enalapril and Metoprolol in view of polymorphism of genes associated with lipid metabolism, renin-angiotensin system, β-adrenoreceptor and apoptosis cascade in patients with essential hypertension. Design and methods. 150 Tatar hypertensive patients were included, and blood pressure monitoring and gene polymorphism determination were performed. Antihypertensive therapy was prescribed for one month. Results. There are associations between antihypertensive efficacy and the number of genetic markers in hypertensive patients. We suppose that protein products encoded by GluR2, HIF-1А, CASP9, Ephrin-B3 genes play a role either in blood pressure regulation or in the mechanism of blood pressure decrease under therapy with Nifedipine Retard, Enalapril or Metoprolol. Conclusion. GluR2, HIF-1А, CASP9, Ephrin-B3 genes polymorphisms can be used to predict the efficacy of treatment with Nifedipine Retard, Enalapril and Metoprolol in hypertensive patients.
Predictive value of hyperhomocysteinemia in pregnant women with chronic hypertension
Authors: Chulkov V. S. , Vereina N. K. , Sinitsin S. P.
Published: December 2018

Objective. To investigate homocysteine ​​levels in pregnant women with chronic hypertension in different terms of pregnancy, and to evaluate the prognostic significance of hyperhomocysteinemia in the development of preeclampsia, placental insufficiency syndrome and fetal growth retardation. Design and methods. It is a cohort prospective study. Pregnant women were divided into 2 groups: group 1 was formed by women with chronic hypertension (n = 80), group 2 consisted of 40 women without hypertension. Results. Pregnant women with chronic hypertension had higher homocysteine ​​levels throughout the pregnancy compared to those without hypertension. Homocysteine ​​level was higher in pregnancy complicated by preeclampsia, placental insufficiency and fetal growth retardation syndrome. Conclusion. Homocysteine ​​levels above 5,8 mmol/l in the III trimester of pregnancy may be used as a prognostic risk factor for preeclampsia development.
Predictors of insufficient response to initial antihypertensive treatment
Authors: Troshina A. A. , Kolesnikova I. A. , Kotovskaya Yu. V. , Moiseev V. S. , Kobalava Zh. D.
Published: December 2018

To compare baseline central pulse wave characteristics in relation to response to initial antihypertensive treatment in previously untreated hypertensive patients. Design and methods. The study included 57 subjects (mean age 50,2 ± 13,7 years) with untreated arterial hypertension grade 1-2 without target organ damage on routine examination. Antihypertensive therapy was initiated after baseline ambulatory blood pressure monitoring (ABPM) and pulse wave analysis. Response to treatment was classified by joint evaluation of ABPM and clinic BP after 8 weeks of treatment. The baseline pulse wave velocity (PWV) was compared in 4 groups: 1) true responders (TR, normal clinic and ambulatory BP), 2) masked responders (MR, elevated clinic and normal ambulatory BP), 3) masked non-responders (MNR, normal clinic and elevated ambulatory BP), 4) true non-responders (TNR, elevated clinic and elevated ambulatory BP). Results. There were 21 (36,8 %) TR, 11 (19,3 %) MR, 11 (19,3 %) MNR, 14 (24,6 %) TNR. MNR was the youngest group but their baseline central systolic, pulse BP and PWV were at least similar or even higher than in the other groups. Conclusion. The results suggest that increased arterial stiffness may be responsible for insufficient response to initial antihypertensive treatment in non-diabetic hypertensive patients.
Transient arterial hypotension in hypertensive patients: interrelations with risk factors and target organ damage
Authors: Protasov K. V. , Boronova V. B.
Published: December 2018

To investigate the prevalence, clinical manifestation and hemodynamic parameters of short-time arterial hypotension episodes in relation to risk factors and target organ damage in elderly hypertensive patients. Design and methods. 260 hypertensive patients aged 75,0 (68-79) years were investigated. The ambulatory blood pressure monitoring (ABPM) was performed. In the ABPM curves the extreme systolic BP falls were identified, and the hemodynamic parameters and circadian structure of these episodes were analyzed. Antihypertensive treatment regimens, prevalence of risk factors, target organ damage and established cardiovascular diseases were compared in patients with and without BP extreme falls. Results and conclusions. We detected 63 short-time BP falls in 48 (18,5 %) hypertensive patients. Most of them (68,8 %) were asymptomatic. Two time intervals of most frequent BP falls incidence were found, including early morning and postprandial hours. BP falls were associated with the total cholesterol level and left ventricular mass increase, reduced glomerular filtration rate, previous myocardial infarction and angiotensin converting enzyme inhibitors administration. These facts should be taken into account when antihypertensive therapy is administered to elderly subjects.
The opportunities of non-invasive ventilation in the treatment of drug-resistant hypertensive patients with obstructive sleep apnea syndrome
Authors: Sviryaev Y. V. , Zvartau N. E. , Korostovtseva L. S. , Konradi A. O.
Published: December 2018

The article reviews the trials in hypertensive patients with obstructive sleep apnea syndrome (OSAS). The relation of arterial hypertension and OSAS and the underlying mechanisms, as well as the possible causes of drug-resistant hypertension are discussed. The results on the use of non-invasive ventilation (so called CPAP-therapy, continuous positive airway pressure) are presented.
Psychological factors of cardiometabolic risk: History and modern state
Authors: Alekhin A. N. , Trifonova E. A.
Published: December 2018

The history of psychosomatic research and current studies of psychological influences on cardiometabolic risk are reviewed. Personality, psychopathological, situational and cognitive-behavioural risk factors are considered. Shortages of current studies are pointed out, the necessity of integration of different psychosomatic approaches as well as the need for individually-oriented investigations are stressed.
Effect of antihypertensive therapy on cognitive function in hypertensive patients with obesity
Authors: Zueva I. B. , Vanaeva K. I. , Sanez E. L. , Moroshkina N. V.
Published: December 2018

Objective. To assess and compare efficacy of perindopril, eprosartan and amlodipine according to their effects on cognitive function in patients with arterial hypertension and obesity. Design and methods. This open clinical trial included 78 patients (mean age — 46,8 ± 5,5 years), 26 of them received perindopril, 26 — eprosartan, and 26 — amlodipine. Monotherapy has lasted for 12 months. At baseline and 12 months later, all participants underwent 24-hour blood pressure monitoring, neuropsychological testing and cognitive evoked potential (P300) to assess cognitive function. Results. Twelve-month monotherapy with eprosartan and amlodipine significantly improved cognitive function (neuropsychological testing and P300) in patients with obesity and arterial hypertension.
FROM LANG TO REAVEN History of the First Department of Internal Medicine at Pavlov St Petersburg State Medical University
Authors: Krasilnikova E. I. , Blagosklonnaya YA. V. , Baranova E. I. , Shlyakhto E. V.
Published: December 2018

The review provides evidence that in the early twentieth century the research on the mechanisms of «metabolic cardiovascular syndrome» was started at the Department of Faculty Therapy in Pavlov St Petersburg State Medical University (that was called St Petersburg Women’s Medical University at that time). The investigations were initiated by G.F. Lang, and extended by A.L. Myasnikov, D.M. Grotel, B.V. Ilyinskiy, V.M. Dilman, V.A. Almazov and others, and based on the results they proposed the concept of a cascade of metabolic syndrome and its main components — obesity, insulin resistance and hyperinsulinemia. Nowadays, as the continuation of those studies, the first epidemiological Russian study NICA (National Investigation of Cardiovascular Complications in mеtАbolic syndrome) is conducted by the employees of the Department of Faculty Therapy and Almazov Federal Heart, Blood and Endocrinology Centre.
Analysis of gene-gene interactions of polymorphic cytokine genes loci in patients with essential hypertension
Authors: Timasheva Y. R. , Nasibullin T. R. , Tuktarova I. A. , Karamova I. M. , Petrin A. N. , Mustafina O. E.
Published: December 2018

Background. Chronic systemic inflammation is a key factor in the pathogenesis of cardiovascular diseases. The exact mechanisms underlying blood pressure elevation are unclear, but recent findings suggest that inflammatory mediators are involved. The objective of our study was to investigate the influence of gene-gene interactions between IL6, IL1B, IL12B, TNF, LTA and IL10 genes polymorphic markers on susceptibility to essential hypertension. Results. In the ethnic group of Tatars residing in Bashkortostan, Russia, we found an association of IL1B rs16944 and IL10 rs1800872 polymorphic markers with the disease. The analysis of gene-gene interactions showed significant synergy between IL12B rs3212227 and TNF rs1800629 polymorphic markers towards essential hypertension. The final model (logistic regression) included IL10 rs1800872 genetic marker and the combination of IL12B rs3212227 and TNF rs1800629 genetic markers as optimal predictors of essential hypertension. Conclusion. Our data confirm the involvement of cytokine system in the development of essential hypertension.
Prehypertension and cardiovascular risk factors in Kursk inhabitants
Authors: Erina A. M. , Rotar O. P. , Solntsev V. N. , Harchenko A. V. , Mihin V. P. , Konradi A. O. , Shlyakhto E. V.
Published: December 2018

Objective. To assess the prevalence of prehypertension and its association with cardiovascular risk factors in Kursk citizens. Design and methods. Cross-sectional study was carried out in one of Kursk outpatient departments during 2010, and 170 patients were screened. All subjects were interviewed with special questionnaire about personal data, lifestyle factors, concomitant medical history and therapy. Blood pressure (BP) was measured 3 times at right hand and anthropometrical parameters were assessed. Serum lipids and glucose were measured by Hitachi-902 equipment (Roche reagents). Metabolic syndrome (MS) was diagnosed according to ATP III criteria (2001–2005), IDF 2005 and harmonized criteria JIS 2009. Results. Comparing subjects with optimal BP, prehypertension and arterial hypertension we found that higher BP levels were associated with the higher prevalence of triglyceridemia and higher values of waist circumference, subjects with higher BP were also older. The number of smokers was twice higher among prehypertensive males than in females. Comparing groups of participants with optimal BP, prehypertension and hypertension we found that MS prevalence was higher in subjects with higher BP levels independently of the criteria applied: NCEP-ATP III, IDF, or JIS. The highest MS prevalence was identified when JIS criteria were applied. Males with optimal BP did not have MS. Females had higher MS prevalence independently of MS criteria, and the higher parameters were found in the group of hypertension. The positive statistical correlations were found between following parameters: systolic BP with age and waist (p = 0,001), diastolic BP with waist (p = 0,001). BP level correlated with triglycerides level in males. Conclusions. Our study showed high prevalence of prehypertension and its association with metabolic disturbances. The early diagnosis of prehypertension and cardiovascular risk factors correction should be performed. The prevalence in our population group was similar with world data, the gender and age particularities were detected.
Arterial hypertension in the view of a patient
Authors: Sergeev V. P.
Published: December 2018

Background. At the present time there are no objective methods that enable definition of the mechanisms of blood pressure elevation in a particular patient. Objective. Based on the results of blood pressure and heart rate measures to find new additional features that could help a differentiated management approach. Design and methods. Literature analysis, model formation and analysis, statistical analysis were performed. Results. The new criteria based on the measurements of blood pressure and heart rate are offered. A new way of reporting the results of blood pressure measurements, and a new computer program for analyses observations with the probability characteristics are offered. Conclusions. The present result can be used for the assessment of blood pressure dynamics, and for check-up of the working hypotheses.
BAROREFLEX AND ADAPTATION OF VISCERAL SYSTEMS IN RENOVASCULAR HYPERTENSION
Authors: Tsyrlin V. A. , Kuzmenko N. V. , Pliss M. G. , Rubanova N. S.
Published: December 2018

Objective. To test the hypothesis, that the arterial baroreceptor reﬂ  ex plays the key role for the phenomenon of visceral systems adaptation for long-term afferent drive.

 Design and methods. In Wistar rats the model of the «two kidneys, one clip» vasorenal hypertension was carried out. The sino-aortic denervation was performed in one group — before the left renal artery clipping, in the other group — 8 weeks after the left renal artery clipping.

 Results. The renal artery clipping led to the increase of blood pressure only in 17 % of animals with intact sino-carotid-aortic mechanoreceptor zones. The absence of hypertension in these animals might be due to the cardiovascular adaptation phenomenon to prolonged afferent action from ischemic kidney. Denervation of mechanoreceptor zones before the clipping of the renal artery contributes to the development of hypertension in 100 %. However, the denervation of sino-carotid and aortic zones performed 8 weeks after the renal artery clipping in rats without hypertension, does not affect blood pressure level.

Conclusion. We suggest, that the absence of hypertension after renal artery clipping is due to the adaptation of the circulatory system to a long-term afferentation from the kidney, and the denervation of large vessels mechanoreceptor zones does not alter this process. At the same time, the damage of the arterial baroreceptor reﬂ  ex before renal artery clipping interferes in the visceral systems adaptation to afferent action and contributes to the arterial hypertension development.
MAGNETIC RESONANCE SPECTROSCOPY IN EVALUATION OF COGNITIVE FUNCTIONS IN PATIENTS WITH METABOLIC SYNDROME
Authors: Zueva I. B. , Moroshkina N. V. , Barantsevich E. R. , Trufanov G. E.
Published: December 2018

Objective. To evaluate the role of magnetic resonance spectroscopy (MR-spectroscopy) in the study of cognitive functions in patients with metabolic syndrome (MS).

Design and methods. The study included patients with MS (10 patients without cognitive impairment and 11 subjects with cognitive dysfunction). All patients underwent neuropsychological testing, and cognitive evoked potential for the assessment of cognitive functions. Brain metabolism was studied by proton MR-spectroscopy.

Results. In patients with MS and cognitive impairment, and without cognitive dysfunction no morphological changes in the brain according to the magnetic resonance imaging (MRI) were found. According to MR-spectroscopy of the brain in patients with MS and cognitive dysfunction the metabolism impairment is primarily associated with the increase in lactate and inositol.

Conclusion. Indicators of neuropsychological testing, the cognitive evoked potential are associated with the violation of brain metabolism in patients with MS and cognitive impairment.
INFORMATION AND DIGITAL TECHNOLOGIES IN PREVENTION OF HYPERTENSION
Authors: Kostin A. V. , Kostina S. A.
Published: December 2018

Objective. To determine the criteria for the application of preventive measures for individual computer program «Medical and psychological prevention of complications, and the normalization of physiological parameters in a hypertensive patient».

Design and methods. With the ﬁnancial support of the Government of the Russian Federation, the State contract № 6464r/9021 of 28.12.2008, we have developed and registered in the Federal Institute of Industrial Property preventive medical computer program «Medical and psychological prevention of complications, and the normalization of physiological parameters in a hypertensive patient» № 2011618469, state registration number 01200951860. We examined 180 patients (120 hypertensives and 60 controls) aged 20–70 years (mean age 35,5 ± 7,2 years), patients of the main group had a primary diagnosis of hypertension (I, II, III degree). We performed clinical neurological, standard laboratory and instrumental diagnostic examinations and psychodiagnostic testing, as well as the pulse measurements by cardiointervalography followed by mathematical analysis of the data by a special program.

Results. Analysis of reactions in the interim period of adaptation (14–21 day) has shown its important role to predict the outcome of preventive measures. According to our data 88,2 % patients with hypertension III degree and 94,4 % patients with hypertension II degree demonstrated normalization of the blood pressure and improvement in general state, and the approach was beneﬁcial in 100 % patients with hypertension I degree. Mean recovery time after hypertensive crisis was 15,0 ± 5,0 minutes in patients with hypertension I degree, 30,0 ± 10,0 minutes in patients with hypertension II degree (p < 0,001), and 45,1 ± 27,4 minutes in patients with III degree (p < 0,05). Patients, who used personal computer software, demonstrated the reduction of irritability, fatigue, improved sleep, memory, increased work efﬁiency, disappearance of sleepiness, and there was an increase in self-conﬁdence.

Conclusions. Thus, our results show that the use of individual computer program «B/P rate» leads to the reduction of the frequency and duration of hypertensive crises, as well as to the improvement of cognitive function and psychosocial parameters.
ARTERIAL HYPERTENSION PREVALENCE IN MOSCOW IN DIFFERENT TIME INTERVALS
Authors: Balanova Y. A. , Shalnova S. A. , Deev A. D. , Konstantinov V. V. , Kapustina A. V.
Published: December 2018

Objective.To assess population mean blood pressure (BP), prevalence, treatment, and control of arterial hypertension from 1975 to 2001 depending on the socio-demographic indicators

Design and methods.Seven independent cross-sectional population surveys were conducted in 1975–2001 with randomly selected men (10094) and women (3527) aged 25–64 years old,Moscow residents, with response > 70 %. We have combined data from studies performed in Soviet period, «the period of perestroika» and post-Soviet period.

Results.Systolic BP (SBP) has increased from «Soviet period» to «the period of perestroika» in men by 2,5 mmHg (р < 0,05), and in women by 5 mmHg (р < 0,001). Diastolic BP (DBP) has increased among men (from 87,0 to 87,8 mmHg, р < 0,02), and among women (from 81,5 to 87,2 mmHg, р < 0,001). In the late 90’s SBP has decreased (in women from 137,5 to 130,1 mmHg, р < 0,02), DBP has decreased (in men — to 85,1 mmHg, р < 0,02, and in women — to 81,3 mmHg, р < 0,005). There was a statistically signifi cant increase in the prevalence of arterial hypertension from «Soviet period» to «the period of perestroika» (from 46,5 to 49,2 % in men; from 38,7 to 50,3 % in women, р < 0,001). In the post-Soviet period it has decreased among men to 39,8 % and among women to 32,7 % (р < 0,04). The rate of adherence to antihypertensive medications has increased (in men from 6,2 to 19,4 %, р < 0,001; and in women from 15,5 to 26,6 %, р < 0,001). The proportion of effectively treated hypertension has decreased (in men from 35,7 to 23,4 %, and in women from 36,9 to 31,7 %). Control of hypertension improved signifi cantly from 3,6 to 5,8 % (р < 0,01).

Conclusion.The prevalence of arterial hypertension remains high. The main objective of physicians is to increase the number of effectively treated patients and to achieve target levels of blood pressure.
THE TIMING OF PUBERTY: WELL-KNOWN AND NEW ISSUES
Authors: Nikitina I. L.
Published: December 2018

Puberty is an important developmental milestone. It can be considered as a complex sequence of biological  events leading to progressive maturation of sexual characteristics ultimately leading to attainment of full  reproductive capacity. The decline in age at puberty in the general population has been paralleled by an increase  in the number of girls referred for evaluation of precocious puberty (PP). The recent pubertal trends have resulted in a concomitant lowering of the lower limit of normality of the pubertal onset. However, evidence suggests that  age at the gonadotropin and sex steroid surges have not changed. Thus, it looks as if an increasing proportion of  contemporary early pubertal girls may experience isolated gonadotropinindependent thelarche rather than central  PP, which may not be discernible on pubertal examination alone. Thus, the population-based limits of normality  srapid progressive PP as well as intracranial and other underlying pathology. The initiation of mammalian puberty  requires an increased pulsatile release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. This  increase is brought about by changes in transsynaptic and glial-neuronal communication. Coordination of these  cellular interactions likely requires the participation of sets of genes hierarchically arranged within functionally  connected networks. The role of kisspeptins in the control of GnRH neurons and the transmission of the regulatory  actions of key signals, such as sex steroids, metabolic hormones and environmental cues, has been recently  studied, point out that the Kiss1 system is an indispensable player of the brain sexual differentiation during early  periods of maturation and the timing of puberty onset.
CIRCADIAN BLOOD PRESSURE PROFILE IN YOUNG SUBJECTS WITH PRE-HYPERTENSION
Authors: Evsevyeva M. E. , Mishchenko E. A. , Rostovtseva M. V. , Galkova I. Y. , Chudnovsky E. V. , Rusidi A. V. , Smirnova T. A. , Ivanova L. V.
Published: December 2018

and arterial hypertension for the planning of timely and effective prevention.

 Design and methods.We enrolled 147 people: with optimal and normal BP — 81, with high normal BP — 30 men, and 36 controls. Ambulatory BP monitoring (ABPM) nas performed in the offi ce at the setting of ≪typical working day≫ or 24 +- 1,5 hours with 15 and 30 minute intervals between the measurements during the day and night, respectively.

Results.Young people with high normal BP differ from the subjects with normal and optimal BP by a variety of ABPM indices. However, the changes are lower, but similar to those observed in patients with evident hypertension, including increase of mean systolic and diastolic BP, time index of systolic and diastolic BP, and morning BP surge. Young men with high normal BP are also characterized by the family history of the early cardiovascular disease and the presence of cardiocerebral complaints with the frequency similar to that in hypertensive subjects.

Conclusions.Young subjects with high normal BP seem to be at higher risk, and should undergo early and effective preventive measures.
UP-TO-DATE VIEW AT THE ROLE OF ASEPTIC INFLAMMATION OF ADIPOSE TISSUE IN THE GENESIS OF OBESITY AND METABOLIC SYNDROME
Authors: Kryukov N. N. , Ginzburg M. M. , Kiseleva E. V,.
Published: December 2018

Over the past two decades the views at the role of adipose tissue in the metabolic and energy metabolism have radically changed. There have appeared more and more evidence on the production of biologically active substances by adipose tissue, the so-called adipocytokines that are involved in the regulation of metabolic processes at the local or systemic level, of the tissue sensitivity to insulin, as well as pro-inlammatory or anti-inlammatory effect. By analysing the relationship and interaction of abdominal obesity, aseptic inlammation of adipose tissue and insulin resistance, it should be emphasized that these processes operate on the principle of mutual reinforcement, forming a vicious circle. Further understanding of adipokines and cytokines participation in the development of obesity and metabolic syndrome may contribute to a deeper insight into their biological role.
RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM IN PATIENTS WITH ABDOMINAL OBESITY AND ARTERIAL HYPERTENSION
Authors: Bazhenova E. A. , Belyaeva O. D. , Berezina A. V. , Karonova T. L. , Kolodina D. A. , Brovin D. L. , Naneishvili T. Z. , Korelskaya N. A. , Ivanova T. G. , Baranova E. I. , Berkovich O. A. , Shlyakhto E. V.
Published: December 2018

Objective. The activity of renin-angiotensin-aldosterone system (RAAS) is increased in patients with ab-dominal obesity (AO). However, till present time it is unclear whether RAAS activation or hypertension (HTN) found in 50 % patients is the primary disorder.

Design and methods. We have studied plasma renin activity (PRA), plasma aldosterone concentration (PAC), their ratio PAC/PRA in patients with AO and related HTN and in subjects without AO.

Results. PRA was higher in patients with AO versus people without obesity (2,5 ± 0,2 and 1,7 ± 0,7 ng/ml/hr, p = 0,013), there was a tendency to the reduction of the ratio PAC/PRA in obese patients (14,6 ± 0,9 and 19,7 ± 3,3, p = 0,08). In the subgroup of patients with AO and HTN the PRA was higher, and the ratio PAC/PRA was lower than in obese patients without HTN (PRA: 3,3 ± 0,4 and 1,7±0,2 ng/ml/hr, p = 0,005; PAC/PRA: 11,4 ± 1,1 and 17,4 ± 1,4, p < 0,0001). PRA and systolic blood pressure positively correlated. In patients with morbid obesity (3 degree according to the WHO classiication) obesity may play a signiicant role in the increase of RAAS activity, especially in the absence of concomitant HTN. The ratio PAC/PRA in over weight patients with AO was higher than in patients with AO and body mass index ? 30,0 kg/m (17,2 ± 1,7 and 12,5 ± 1,0 kg/m, p = 0,04). PRA was higher only in patients with AO and co-existing hypertension (3,4 ± 0,7 and 1,1 ± 0,2 ng/ml/hr, p = 0,04).

Conclusions. RAAS activity is increased in patients with AO, also due to the co-existing HTN. However, in the absence of elevated blood pressure obesity per se may play a signiicant role in RAAS hyperactivity.
HYPERTENSION OFFICE: OPPORTUNITIES AND PROSPECTS FOR PRIMARY HEALTH CARE
Authors: Paskar N. A.
Published: December 2018

Objective. To analyze the work of the Hypertension office to explore the risk factors of cardiovascular disease and prevention opportunities.

Design and methods. The study included 2049 subjects (1549 women and 500 men) surveyed in 10 Hypertension offices. The special software «Cardiometer-MТ» JSC «MICARD-LANA» (Russia) was used for the automated integral estimation of the functional state of the cardiovascular system.

Results. The fatal cardiovascular risk by the SCORE scale was estimated: very high risk was observed in 33,7 % cases, high risk — in 31,1 %, moderate risk — in 12,4 %, low risk — in 19,7 % cases.

 Conclusions. The methods applied in this work contribute to the development of the database and to the primary prevention in people with cardiovascular risk factors.
Perancangan Sistem Informasi Manajemen Kas Berbasis Web Studi Kasus: RS dr. Etty Asharto Batu
Authors: Supriyono Supriyono , Muslimah Endah
Published: December 2018

Pengelolaan data keuangan perusahaan merupakan hal yang perlu mendapatkan penanganan yang tertib, terstruktur dan transparan. Penerapan sistem informasi manajemen keuangan dapat dijangkau melalui situs lokal yang memberikan rincian data penerimaan kas dan pengeluaran kas. Metodologi yang digunakan didalam penelitian berikut menggunakan metode waterfall. Hasil dari penelitian berikut ini berupa sebuah perancangan sistem informasi yang mampu mengelola pemasukan kas dan pengeluaran kas. Sistem informasi pengelolan kas masuk dan kas keluar dirancang menggunakan database MySQL, bahasa pemrograman PHP, dengan tampilan user interface menggunakan Bootstrap dan kerangka kerja menggunakan framework Codeigniter. Dengan menggunakan analisa dan perancangan sistem serta rekayasa kebutuhan dapat menghasilkan sistem informasi yang handal dan tepat guna. Sistem informasi pengelolaan kas masuk dan kas keluar pada Rumah Sakit dr. Etty Asharto Batu mampu memberikan manfaat bagi pegawai dalam proses pencatatan.