The study investigated the medical assessment of arterial hypertension (AH) severity and its association with seeking urgent medical assistance (ambulance calls and hospitalizations). The main criteria for medical assessment of AH severity were the patients’ self-evaluation of their status, systolic blood pressure level, and self-assessment of the pre-administered AH therapy effectiveness. The prognostic value of medical assessment of AH severity was relatively low, with sensitivity of 51% and specificity of 74% for visual analogue scale (VAS) assessment (≥55 points). The more accurate instrument for assessing the risk of seeking urgent medical assistance was the SCORE risk scale (risk level ≥2,4%). Patients’ self-assessment of their status with VAS had additional prognostic value. All three methods combined could result in sensitivity of 90%, but specificity of 34%. The doctors linked their assessment of AH severity with a necessity to use more antihypertensive medications in more severe patients. However, among patients with medically assessed severity ≥55 VAS points, adding indapamide retard to the therapy resulted in a significant reduction in the risk of seeking urgent medical assistance (odds ratio 0,36; 95% confidence interval 0,20-0,73). No such effect was observed in medically assessed “non-severe” patients.

In 68 patients with clinical, anamnestic, laboratory, and ultrasound evidence of chronic hepatic parenchymal disease and secondary cardiomyopathy, a range of electrocardiographic parameters was investigated, in accordance with the leading hepatic syndrome. Among the individuals with hepatic secondary cardiomyopathy, the most informative parameters, determining the severity and prognosis of the disease, were the following: the number of supraventricular and ventricular extrasystoles; myocardial ischemia duration; segment ST depression/elevation area; QT interval dispersion; and temporal parameters of heart rate variability. These parameters were more disturbed in patients with the leading syndromes of cytolysis and cholestasis, in comparison to the participants with the leading syndromes of hepato-cellular failure.

Based on the data from 17 healthy volunteers and 110 patients with arterial hypertension (AH) and chronic heart failure (CHF), who underwent combined 24-hour monitoring of diuresis and blood pressure (BP), with three-hour and functional intervals (morning, midday, evening, night-time, and circadian) assessed, a complex parameter “diuresis – tension ratio” (DTR) was developed. This parameter reflects the ratio between diuresis (percentage of excreted to consumed water) and mean systolic BP (SBP) during the time (t) of diuresis measurement (DTRt = diuresis, % / mean SBP, mm Hg). In healthy people, normal DTR values were in the range of 75-90% / 120-135 mm Hg. In AH patients, fluid retention and BP increase in morning, midday, and, to a lesser extent, evening intervals were observed. Compensatory increase in night-time diuresis was inadequate in patients with CHF, being associated with circadian diuresis reduction to <65% and oedema development. The latter was an indication for diuretic therapy. The assessment of circadian DTR dynamics demonstrated the benefits of loop diuretic torasemide (5 mg), which had stronger, more even and long-lasting effect, comparing to hydrochlorothiazide (100 mg) and furosemide (20 mg). DTR assessment could be recommended for diagnostics of fluid metabolism disturbances and the choice of the optimal diuretic therapy regimen.

Aim. To investigate effectiveness and safety of trimetazidine MB in the complex treatment of stable angina. In total, 90 patients were examined – 57 women and 33 men aged 48-70 years (mean age 61,4 ± 6,03 years). All participants received trimetazidine MB (Deprenorm MB) for 3 months (35 mg twice per day). The treatment was associated with reduced angina attack incidence and decreased dose of isosorbide dinitrate, taken during angina attacks. Functional class (FC) of angina was also reduced. Conclusion. Deprenorm MB could be recommended for complex treatment of the patients with coronary heart disease and stable effort angina, who already receive standard anti-anginal therapy.

The study compared the effects of cardiocytoprotectors (mildronate, trimetazidine) on endothelial function, physical stress tolerability, and circadian blood pressure (BP) profile in patients with arterial hypertension (AH; n=60) and stable angina (n=82), receiving anti-anginal therapy (beta-adrenoblockers, nitrates) or antihypertensive therapy (enalapril). Adding cardiocytoprotectors to the complex therapy improved endothelium-dependent vasodilatation and circadian BP profile, as well as reduced endothelial dysfunction severity and intima-media thickness in AH patients. Mildronate was more effective in improving endothelial structure and function.

The paper focuses on the co-morbidity of coronary heart disease (CHD) and anxiety and depressive disorders. The effects of psycho-emotional pathology on quality of life are discussed. The importance of complex treatment, including selective psychotropic therapy, is emphasised.

In total, the study included 60 45-64-year-old patients in early post-infarction phase, with chronic heart failure (CHF), Functional Class II-III, and metabolic syndrome (MS). The patients were randomised into two groups (n=30 in each group). In the main group, standard CHF therapy was extended by adding mexicor (0,4 g/d). The study lasted for 12 weeks. Cytoprotector mexicor, as a part of complex CHF therapy, reduced HF severity, improved quality of life, and demonstrated anti-anginal effects. In MS patients, mexicor improved myocardial contractibility, diastolic function, autonomous control of heart function, glomerular filtration rate, lipid and carbohydrate metabolism, and insulin sensitivity.

The review is devoted to modern pharmaceutical treatment of pulmonary arterial hypertension (PAH). In 1970-80s, it was based on high-dose calcium antagonists, CAs (e.g., nifedipine 240 mg/d), which were effective only in some patients with primary (idiopathic) PAH. CAs were combined with digoxin, indirect anticoagulants and oxygen. In 1990s, PAH therapy included prostanoids, endothelin receptor (ER) blockers and phosphodiesterase (PDE) inhibitors, which are more selective pulmonary vasodilatators than CAs, and therefore are safer for long-term treatment. Prospective studies have demonstrated that continuous intravenous infusion of epoprostenol and ET receptor blocker bosentan treatment improve survival of PAH patients receiving traditional therapy. Clinical effectiveness of epoprostenol is similar to that of subcutaneously administered trepostinil, and bosentan is similar to PDE inhibitor Type 5 sildenafil. Bosentan increases the effectiveness of intravenous epoprostenol and inhaled trepostinil.