To clarify the specific features of renal dysfunction and their role in arterial hypertension (AH) progression, in 60 men of draft military age (16-26 years) and 79 parents, a complex clinical, laboratory and instrumental examination was performed. It included plasma uric acid and microalbuminuria measurement, dynamic and static scintigraphy, renal ultrasound tomography, renal artery Doppler ultrasound, echocardiography, and 24-hour blood pressure monitoring. The patients with AH, hyperuricemia, and nephropathy demonstrated microproteinuria, cylindruria, reduced tubular concentration ability, and disturbed renal secretion and excretion, typically bilateral. Individuals with hyperuricemic nephropathy more often had renal disease, diabetes mellitus, or obesity in family history, demonstrated higher levels of plasma creatinine and glucose, as well as higher prevalence of obesity and left ventricular hypertrophy. Hyperuricemic nephropathy should be considered as a separate form of secondary AH.

The changes in central and intracardiac hemodynamics were investigated among elderly patients with isolated systolic and systolo-diastolic arterial hypertension (ISAH, SDAH). Inn total, 102 patients with Stage I-II AH were divided into two groups: the main group (37 ISAH individuals) and the control group (65 participants with SDAH), comparable by age and gender structure. All participants underwent standard Doppler echocardiography. Left ventricular (LV) stroke volume, LV endsystolic and end-diastolic sizes, ejection fraction (%), and ΔS (%) were registered. LV myocardial mass (LVMM) and LVMM index were calculated. Total peripheral resistance was assessed non-invasively, using standard formulae. In ISAH patients, disturbances of intracardiac and central hemodynamics and LV geometry were observed, which should be considered while assessing risk level, disease prognosis, and potential therapeutic strategies.

In patients with myocardial infarction, the dynamics of acute phase proteins (APP), oxidative stress and white blood cell functional activity was investigated. A statistically significant increase in APP levels was observed starting from Day 1, reached its peak at Day 7, and disappeared by Day 28. Acute phase parameters correlated with oxidative stress characteristics. APP levels were higher in patients with more severe clinical course. The rate of haptoglobin concentration reduction was higher in participants receiving ACE inhibitors, comparing to the control group. Therefore, ACE inhibitor therapy might affect inflammation and sclerosis processes in the infarction area.

The study included 95 men, who underwent a rehabilitation course at the Ashgabat resort in four or more months after myocardial infarction. Left heart functional reserve was assessed by standard parameters, such as chamber sizes, left ventricular (LV) ejection fraction, LV myocardial mass, and the size of dyskinetic zones. Based on these characteristics, a coefficient of myocardial reserve utilization (CMRU) was calculated. This coefficient provided a complex assessment of left heart function and functional reserve. It also helped to identify the patients with reduced left heart reserve, in whom physical training did not result in substantial improvement of cardiovascular function. In these patients, physical training is associated with higher risk, due to more severe myocardial ischemia and higher incidence of cardiac arrhythmias. Therefore, this clinical group needs a less intense programme of physical training.

The study investigated the effects of cardiac cytoprotectors – mildronate and trimetazidine, combined with ACE therapy, on lipid peroxidation product levels, endothelial function, circadian blood pressure (BP) profile, left ventricular myocardium, and intracardiac hemodynamics in patients with arterial hypertension (AH). It was demonstrated that in AH patients, the combination of mildronate and enalapril facilitated lipid peroxidation reduction, endothelial function and circadian BP normalization, as well as improvement of left ventricular morphology and function. The combination of trimetazidine and enalapril did not improve the effectiveness of antihypertensive therapy.

The study assessed oxycardin effects on hemostasis and blood rheology in 82 patients with stable angina, Functional Class II-III. In all participants, main parameters of hemostasis, blood viscosity, and red blood cell aggregation and deformation were investigated. Oxycardin course resulted in significantly reduced platelet aggregation, without affecting plasma hemostasis. A reduction in blood viscosity (shift rate 20 s-1) and in platelet aggregation index was also observed. Oxycardin combination with long-term aspirin therapy resulted in further reduction of platelet functional activity. The results obtained confirm oxycardin anti-aggregant activity and its beneficial influence on blood rheology.

The molecular effects of trimetazidine and mildronate were investigated in patients with stable effort angina, Functional Class (FC) I-III. The comparison criteria included blood activity and concentrations of the main products of free-radical oxidation and the components of Krebs cycle and anti-oxidant system. Proteomic methods were also used. Trimetazidine and mildronate could be recommended as cardio-protectors in primary and secondary prevention of FC I-III coronary heart disease.

Wide prevalence of arterial hypertension (AH) and low effectiveness of AH treatment present one of the most important healthcare problems. This study was aimed at assessing the five-year dynamics of AH prevalence, risk factors, and treatment in Ryazan Region. A representative sample of the Ryazan Region population, initially examined in 2002, as a part of the Russian Epidemiological Study “EPOCHA”, was re-examined. Socio-demographic characteristics, medical history, current clinical status and pharmaceutical therapy were assessed. During the last five years, the AH prevalence increased from 36,6% to 39,3% (p=0,07). The percentage of patients taking antihypertensive medications also increased. Improvements in both quantity and quality of antihypertensive drugs taken were associated with an increase in the number of the patients with effectively treated AH.