It is traditionally believed that in acute myocardial infarction (AMI) morbidity and mortality levels are higher for men than for women. At the same time, lethality and survival rates in patients with cardiogenic shock (CS) vary, being age and gender-dependent. Lethality and survival analysis in 103 individuals with AMI and CS was performed. Lethality in CS had an exponential character. Lethality median was 25, 5 hours. Lethality and survival differences in men and women were statistically significant (p < 0,05).

The aim of the study was to compare 24-hour blood pressure (BP) profile in elderly patients with borderline arterial hypertension (BAH) and in subjects with more advanced AH stages. Ninety-nine elderly pateints (mean age 72+4 years) were examined. Twenty-four-hour BP monitoring (24-hour BPM) was performed with a device «MDP-NS- 01» (Russia), by standard methodics. BAH in the elderly is charaterised by higher than in other AH stages, prevalence of white-coat hypertension, and its relative prevalence in the isolated systolic hypertension structure. In the elderly patients with BAH, «pressure load» was relatively high, like in advanced AH stages, due to high systolic BP for all time intervals. Such patients were charaterised with various 24-hour rhythm disturbancies of systolic and diastolic BP. In general, these disturbancies resembled such disorders in advanced AH stages. Elderly hypertensive patients with BAH had high BP variability, mostly due to systolic BP variations.

A survey on arterial hypertension (AH) severity and renin-angiotensin-aldosteron system activity in primary hypothyrosis was performed. Itwas demonstrated that such patients had II and III Stage of AH, with severity progression in older age, and more pronounced abnormalities of 24-hour blood pressure profile at advanced AH stages. Plasma renin activity and aldosteron concentration were within normal range, but lower than the same parameters in essential arterial hypertension.

The aim of the study was to evaluate the association between markers of endothelial function and arterial hypertension (AH). We measured the plasma level of nitrite and nitrate and flow-mediated vasodilatation of the brachial artery (endothelium dependent) in 148 men with AH and 32 healthy men in age 18-24 years. The low level of nitrite was found in 140 patients with AH compared with control group (odds ratio 29, 2; 95 %CI [9, 6-92, 1]). Flow-mediated vasodilatation of the brachial artery was measured in 126 men with AH and it was impaired in 66 men (70,2 % ) (odds ratio 7, 1; 95 %CI [2, 6-19. 7]). There is no significant difference between groups in endothelium independent vasodilatation to nitroglycerin. Endothelial dysfunction was documented in patients with and without left ventricular hypertrophy. Logistic regression analysis using AH as a dependent variable revealed a statistically significant association with nitrite (p=0, 02), flow-mediated vasodilatation (p=0, 046) and genetically predisposition to arterial hypertension.

Autonomic regulation in patients with post-infarctial cardiosclerosis (PICS) and chronic heart failure (CHF) was investigated. Eighty-eight patients with PICS were examined. Various cardiovascular tests, heart rate variability, and central hemodynamic parameters were assessed with integral rheography method at rest and during orthotest in Groups 1 and 2. Group 1 included patients with PICS and CHF, Group 2 - with PICS only. Compared with Group 2, Group 1 had more pronounced abnormalities of sympathic and parasympathic autonomic nervous system (ANS), lower heart rate variability, autonomic shift to sympathic hypertonus, and less balanced reaction to orthotest. Such a dynamics of heart rate variability and hemodynamic parameters at rest as well as during orthotest in patients with PICS and CHF is an evidence of more advanced disturbancies of autonomic regulation and hemodynamics in this clinical group.

Dynamics of left vetriculum and large artery wall elasticity in post-infarctial aneurysm formation are described. Myocardial and vascular status is assessed with a volume-resistance cirulation model. The model is proposed for diagnosing individual hemodynamic features and assessing efficacy of various pharmaceutical and non-pharmaceutical interventions.

The study is devoted to long-term prognosis in women with gestational arterial hypertension (GAH) in anamnesis. A retrospective epidemiological study of GAH clinical importance in women with essential AH was performed. In AH group, more than 50 % women had GAH syndrome in anamnesis. As a rule (45 %), this syndrome included chronic AH (AH before pregnancy or diagnosed before 20 weeks of gestation). Low birthweight in children predicted AH risk in their mothers. Inpatients with AH and GAH syndrome, the clinical course was more severe (higher risk of target organ damage, early cerebrovascular complications, coronary heart disease) than in AH patients without GAH syndrome. In AH/GAH women, genetic factors were less important than in AH women without GAH. More than a half of GAH patients (62,3 % ) received anihypertensive therapy. The latter did not affect significantly obstetric complication risk, labor outcome, and long-term prognosis in women. Only 34 % of GAH patients received an advice to continue the cardiologic follow-up after birthgiving. GAH syndrome should be considered as an independent cardiovascular risk factor. Women with GAH should be in focus of cardiologists' special attention, even if blood pressure level normalized post-partum. Such patients require regular medical examination and active cardiovascular prevention.

Cerebral blood flow, blood rheology and viscosity during 6-month rilmenidin therapy (Albarel, Egis) were measured in 50 patients with arterial hypertension (JNC VII, 2003). Rilmenidin was administered once a day, in the dose of 1-2 mg/d. Total cerebral blood flow and venous drainage, assessed with Doppler ultrasonography, were initially reduced. By the end of the study, they increased significantly, by 16 % and 12,5 %, respectively. Rheology and viscosity parameters improved substantially, too.

In 57 patients with stable effort angina, functional class II-III, and episodes of silent myocardial ischemia, antianginal and antiischemic efficacy of trimetazidine, isosorbide-5-mononitrate, and nadolol (monotherapy and combined therapy) was compared. According to the results obtained, trimetazidine had sufficiently high efficacy and safety. Nevertheless, antiischemic efficacy of nadolol was higher than that for isosorbide-5-mononitrate and trimetazidine. Combination of trimetazidine and hemodynamically active preparations did enhance antiischemic action, without adverse circulatory effects. This additive effect was maximal for trimetazidine and nadolol combination.

In 20 patients with arterial hypertension (AH), ACE inhibitor lisinopril (dapril) was administered as monotherapy for 11, 6 weeks. Mean age of the participants was 56+/-9, 67 years. Group 1 included 8 patients with chronic heart failure (CHF) symptoms, Group 2 - 12 patients without CHF. In Group 1, mean dapril dose was 19, 38 mg/d, in Group 2 - 9, 85 mg/d. For 4 patients from Group 1 and 1 patient from Group 2, due to monotherapy inefficacy, hypothiazide (12, 5 mg/d) was added. The complex clinical examination included 24-hour blood pressure monitoring (24-hour BPM), left ventricular diastolic function assessment with Doppler echocardiography, endothelial response measurement by D. Celermayer method (1992), and quality-of-life evaluation by international scales. Among patients with AH and no CHF, dilapril monotherapy more effectively decreased systolic and diastolic BP levels, pressure load, in comparison to CHF group. A significant diastolic function improvement was observed in both groups. Endothelial response improved only in non-CHF patients. Quality-of-life improved susbstantially in both groups.

The results of the dynamic follow-up of acute myocardial infarction (AMI) pre-hospital period (PHP) in Tomsk City (1984-1998) are presented. Total PHP duration did not change significantly, averaging 9, 5 hours per patient. The biggest time loss (>50 % of the total) was associated with its first period, being explained by late request for medical help in AMI patients. Minimal time loss was typical for the second AMI period, due to organization of special cardiac help for this category of patients. Reduction in the third period duration was explained by improved AMI diagnostics in primary care facilities. As a potential reserve for further reducing AMI PHP time, more active health education of cardiovascular patients by out-patient doctors could be recommended. Methods for further improvement of AMI diagnostics at Tomsk City out-patient clinics are proposed.

Prognonostic value of dynamic bicycle stress test was investigated in adolescents with arterial hypertension (AH). The study included 85 patients who underwent bicycle stress test in continually increasing workload regimen at adolescent age and 6-12 years later. Among individuals with AH progression during 9 years of follow-up (n=36), a typical hypertensive reaction to dosed physical stress was observed, with slow blood pressure recovery, during both tests. Patients with AH regress (n=49) at both tests demonstrated adequate BP reaction to physical stress, typical for healthy individuals. Therefore, hypertensive reaction to dosed physical stress in adolescents is a poor prognostic sign - for patients with debuting AH, as well as for AH-prone individuals.