Vol 13, No 1 (2016)

The article focuses on the use of b-blockers for the treatment of arterial hypertension (AH). Given the situation of modern Russian and European recommendations about the place of b-blockers in the treatment of AH, including their benefits with a combination of hypertension with coronary heart disease, chronic heart failure, atrial fibrillation. Analyzed the efficacy and safety of b-blockers in diabetes mellitus, metabolic syndrome, dyslipidemia, peripheral artery, chronic obstructive pulmonary disease, sexual dysfunction, in individuals of different age and gender. It is emphasized that the selection of b-blockers inside of a class is determined by its selectivity, the study in clinical studies, pharmacokinetic characteristics. Data about efficiency and safety of application of metoprolol succinate.

Aim. Compare the effectiveness of treatment with bisoprololum or sotalolum in patients with hypertensive disease (HD) and ventricular arrhythmias (VA) taking into account quantitative evaluation of the regulatory adaptive status (RAS).Materials and methods. 48 patients with HD of stages II-III and VA of grade I-IV based on the В.Lown grading system, II-III groups based on J.Bigger grading system took part in the research, they were randomized into two groups for treatment with bisoprololum (6.2±1.7 mg/day) or sotalolum (159.1±47.4 mg/day). As part of combination therapy, patients were administered lisinoprilum (12.8±4.2 mg/day and 13.7±4.5 mg/day), acetylsalicylic acid when required (93.1±19.0 and 95.0±16.2 mg/day), atorvastatinum (15.9±4.6 mg/day and 15.6±4.9 mg/day), respectively. Initially and 6 months after therapy, the following was done: quantitative assessment of RAS (by cardio-respiratory synchronism test), echocardiography, triplex scanning of brachiocephalic arteries, treadmill test, six-minute walk test, all-day monitoring of blood pressure and electrocardiogram, subjective assessment of quality of life.Results. Both drug regimens comparably improved structural and functional condition of the heart, increased exercise tolerance, controlled arterial hypertension, effectively suppressed ventricular arrhythmia, improved the quality of life. At the same time, the use of sotalolum decreased the RAS to a lesser degree than the use of bisoprololum.Conclusion. In patients with HD of stages II-III and VA the use of sotalolum as part of combination therapy may be preferable to bisoprololum due to its less negative impact on the RAS.

Aim. To assess the possibility of monotherapy with perindopril after transferring from combination therapy with losartan and hydrochlorothiazide with respect to correction of the anthropometric, metabolic parameters, premature vascular aging and vascular elasticity in patients with metabolic syndrome. Material and methods. Held open prospective controlled study of 50 patients with metabolic syndrome (IDF, 2005), which reached BP<140/90 mm Hg during three months of therapy with losartan (50 mg) + hydrochlorothiazide (12.5 mg) with conversion to monotherapy with perindopril 10 mg for 12 weeks. Patients were evaluated anthropometric and metabolic parameters, levels of adipokines, and indices of vascular elasticity and age was estimated on the date of the transfer with casinadirosa combination monotherapy with perindopril and after 12 weeks thereafter.Results. The results of the study demonstrated the possibility of a transfer with combination antihypertensive therapy monotherapy perindopril patients with metabolic syndrome that contributes to slow vascular aging, improve the elasticity of blood vessels, reduces inflammation and has a beneficial impact on adipokines.Conclusion. When achieved BP<140/90 mm Hg on combination with a thiazide diureticpossible in patients with MS monotherapy perindopril with consequent improvement in elasticity of blood vessels and of adipokines.

The article provides information about the class of non-coding RNA (microRNA), their role in the diagnosis of chronic heart failure and the results of a pilot study.

The purpose of the study is to determine the spectrum used drugsslows the heart rate in patients with arterial hypertension and chronic heart failure in clinical practice and compliance of prescribing with clinical guidelines.Materials and methods. Consistently formed a retrospective sample of medical records of patients with arterial hypertension and chronic heart failure. Used sources of primary medical documentation for 2012-2015 (320 patients). Estimated the amount and quality therapyslows the heart ratein patients with arterial hypertension and chronic heart failure.Results and discussion. b-blockers prescribed for 72.5% of patients. Calcium antagonists range recommended by 13.1%. On the background of optimal doses of b-blockers in patients with arterial hypertension and chronic heart failure with the exile faction of less than 40 and heart rate more than 70 BPM, ivabradine is not assigned in 81.3% of patients, although it is in these situations of particular urgency is the drug given its bright positive effect on hard end points, proved in international multicenter trials.