Vol 12, No 2 (2015)

In 163 patients we compared the therapeutic efficacy and safety of a single sublingual original moxonidine (Fiziotenz, Abbott) and generic moxonidine (Tenzotran, Actavis Group) in the provision of emergency medical services in the case of high blood pressure. It was found that the original moxonidine (Fiziotenz) and generic moxonidine (Tenzotran) are effective to provide emergency medical services with an increase in blood pressure, especially in patients with hypersympathicotonia. At the same time, generic Tenzotran lowers blood pressure less and later than Fiziotenz, the original drug. Adverse effects after using both drugs were not expressed and rare.

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

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

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

The class of drugs - calcium antagonists (CA), or calcium channel blockers (CCBs) is combined a quite heterogeneous drugs group possessing common vasodilatatory characteristics by disruption of the movement of calcium through the vascular smooth muscle cells and with different degree of impact on myocardium, the sinus node function, atrioventricular conduction, tonus of peripheral vessels and coronary blood flow. The existence of this class of drugs has become one of the great achievements in the field of pharmacology, at the end of the 20th century. Third Generation CCBs takes the special place in hypertensiology because of high bioavailability and tissue selectivity. Modern long-acting CA are widely used in case of arterial hypertension (AH), they can be used especially in patients with diabetes mellitus, peripheral artery disease, chronic obstructive pulmonary disease and bronchial asthma, ischemic heart disease and in elderly patients with systolic AH. These drugs show not only antihypertensive effect and organoprotective characteristics, but also can improve the prognosis in patients with high and very high cardiovascular risk.

Aim: to study the possibilities of electrocardiographic and decartographic parameters to identify and assess the severity of overload of the right ventricle in pulmonary arterial hypertension (PAH) patients. Material and methods. Decartographic parameters of the activation duration and repolarization acceleration were studied in 120 patients with PAH and 120 healthy individuals compared to traditional ECG criteria of right ventricular hypertrophy. Moderate increase in systolic pulmonary artery pressure (SPAP) was determined as SPAP 30-50 mm Hg; severe as SPAP greater than 50 mm Hg. Results. The most informative decartographic indicators for the separation of the PAH group as a whole, and the subgroup with moderate increase in SPAP and normal group were the X and Z components of the repolarization acceleration vector and the index of activation duration, and for the separation of subgroups with moderate and severe increase in SPAP - Y component of the repolarization acceleration vector and index of activation duration. Decartographic parameters were more informative as compared with ECG criteria. Conclusion. In patients with PAH decartographic parameters can be useful for detecting the overload of the right ventricle and the assessment of its severity.

On behalf of the group of russian researchers. The aim of the VICTORY study was to estimate the efficacy and safety of valsartan monotherapy using different dose regimes (Valsacor® 80, 160, 320 mg) and its fixed combination with hydrochlorothiazide (HCTZ) using different dosage regimens [Valsacor® H160 (valsartan 160 mg + HCTZ12.5 mg), Valsacor® H320 (valsartan 320 mg + HCTZ 12.5 mg) Valsacor® HD320 (valsartan 320 mg + HCTZ 25 mg)] in reaching the target level of blood pressure (BP) in patients with 1-2 degree arterial hypertension (AH).Materials and methods. There are 130 patients with 1-2 degree AH were enrolled in the open international multicenter prospective randomized study from 7 cities in 8 Russian Clinical Centers in Russia. The starting dose of valsartan depended upon the previous antihypertensive treatment: for previously untreated patients - 80 mg (Valsacor® 80 mg, KRKA, Slovenia) with randomization into 4 parallel groups (n=108) for the patients receiving antihypertensive therapy during the screening, after washout 7-day period of Valsacor® 160 mg application with randomization into 8 parallel groups (n=22). Besides the dynamics of clinical BP, we evaluated the impact of therapy on pulse ware velocity, erectile function (in men) and the quality of life. Results. The clinical BP in 130 patients with AH with age of 55.6±11.5 years (65% women) at the moment of inclusion into the study was 157.6/95.1 mm Hg. The BP was reduced to 140.9/85.3 mm Hg on the 4-week of valsartan 80 or 160 mg application. Valsartan titration or the combination of valsartan and HCTZ on the 8-week helped to reduce BP to 135.2/83.5 mm Hg. The 16-week treatment showed the BP reduced to 129.2/79.4 mm Hg. ( p <0.000001). The therapy was statistically significant reducing the level of heart rate and did not affect aortic augmentation index and the condition of erectile function. The percentage of patients who had the departure from normal blood glucose levels, creatinine and potassium, did not increase since the beginning of the study till the 16-week of treatment. Adverse effects were observed in 9.2% of patients, the connection with the drugs was assessed as improbable and in one case as possible, the severity - was moderate or slight.Conclusions:Valsartan monotherapy and the combination of valsartan and HCTZ significantly reduce the systolic BP and diastolic BP to normal levels in patients with 1-2 degree arterial hypertension.As a result of valsartan therapy and the combination with HCTZ the target BP values were achieved at 91% of all patients involved in the study.Valsartan monotherapy and the combination of valsartan and HCTZ led to heart rate reduction and did not affect aortic augmentation index.Therapeutic effect was very good in 89.1% of the patients and good - in 7.0%.The overall clinical efficiency was measured as extremely high in 73.4% of patients, very high - in 15.6% and high - in 6.3%.On assessing the impact of the therapy on the quality of life of patients we noted that 78.7% of patients were in good health, and in 18.1% of cases the treatment did not worsen the general well-being of the patient.

Studies in recent decades suggest that slowing down the aging process is now real. We describe a number of physiological processes, which may affect the mortality and age-related deterioration of the functional state. One of the most studied impact is to limit caloric intake, which implies a decrease in daily caloric intake by 30-50% compared with an unlimited meal.Showing the effects of GST on the total risk of developing cardiovascular disease, different biomarkers of aging in people without obesity, blood pressure, and others.