To assess the prevalence and type of changes in endocrine organ status and hormonal levels, as well as to investigate their possible role in hypertensive crise development among patients with Stage I?III primary arterial hypertension, AH (WHO classification, 1997), 563 persons with diagnosed hypertensive crise were examined (189 men and 374 women aged 19–67 years). The comparison group included 619 patients (207 men and 412 women aged 25–66 years) with AH of similar severity, but without crises. Clinical, biochemical, and instrumental search for possible AH causes was performed. Basal blood concentrations of hormones and other bio?substances in blood plasma and urine were measured by radio?immune method, at Days 1–7 and 18–22 of hospitalization (ACTH, LH, STH, FSH, prolactin, aldosterone, cortisol, thyroxin, triiodthyronin, thyroxin?binding globulin, insulin, C?peptide, estradiol, testosterone, calcitonin, parathyroid hormone, gastrin, renin, cAMP and cGMP). In crise?associated primary AH, the levels of hypophysis tropic hormones were elevated (thyrotropin, in women of reproductive and menopausal age – gonadotropins LH, FSH, and prolactin), without any signs of hypophysis pathology during instrumental examination. Crise?associated AH was characterized by low?renin hyperaldosteronism, with suprarenal pathology signs, but without symptoms of fluid detention. In patients with AH crises, metabolic syndrome components (obesity, dyslipoproteinemia, hyperinsulinemia) were more common. Frequent AH crises were associated with basal hyperinsulinemia and dysbalance in urine cAMP/cGMP excretion.

Aim. To study heart remodeling in patients with rheumatoid arthritis (RA) and/or arterial hypertension (AH); to identify clinical features of each remodeling type in individuals with RA and AH. Material and methods. In total, 257 patients were examined: 112 with RA and AH, 105 – with RA only, and 40 – with AH only. Heart structure and function was assessed by ultrasound method (“Acuson Aspen”, USA). 

Results. Pathological left ventricular (LV) remodeling types were observed in 97,5 %, 87 %, and 96,4 % of patients with AH only, RA only, and RA combined with AH, respectively. Concentric LV hypertrophy was typical for AH subjects (85 %). In RA subjects, all three LV remodeling types were observed: eccentric hypertrophy (22,3 %), concentric hypertrophy (27,2 %), concentric remodeling (36,9 %), together with normal heart geometry (13 %). In participants with AH and RA, LV remodeling types were similar to those in participants with isolated AH. Conclusion. In patients with AH and RA, eccentric LV remodeling was typically associated with early manifested RA, while concentric LV hypertrophy development was mostly determined by AH clinical course.

The aim of the study was to identify frequency characteristics of heart rate variability (HRV) in ventricular extrasystolia (VES). The HRV data of 34 VES patients treated at the Republican Research Center for Emergency Medical Care in 2006 (515 men and 19 women; mean age 57,6±6,6 years) were analyzed. VES verification was performed using 24?hour Holter ECG monitoring data. Frequency HRV analysis was performed by spectral method (Fourier), with standard (“MS Excel 97”, “Statistica 6.0”) and special programs. In VES patients, relative spectral density was decreased for low frequencies and increased for high ones, with emphasized HF?2 area. Relative decrease in mean frequency ratios, typical for VES, was accompanied by expected increase in LF/ULF. Therefore, frequency characteristics of HRV in VES patients not only reflect autonomous regulation balance, but also provide important diagnostic information on disturbances in vascular tone, central and neuro?humoral regulation mechanisms. Systematic approach towards pathogenetic mechanisms of VES development and progression provides an opportunity to study this type of heart pathology in connection with other organs and systems.

Clinical and psychological examination was performed in 320 patients, 18–20 days after diagnosing acute myocardial infarction (AMI). In 56 %, anxiety and depressive symptoms were observed. These patients, comparing to those without psychological disturbances, demonstrated greater manifestation of autonomic dysbalance during heart rate variability (HRV) assessment (increased sympathetic and deceased vagal activity). Disturbed HRV correlated with progressing anxiety and depression. In sudden death group, psychological and HRV disturbances were substantially more manifested, regardless of AMI clinical course severity. This could trigger fatal arrhythmia development. In participants with anxiety and depression symptoms, including those with sudden death, personality anxiety level was higher.

The study was aimed at investigating the effects of a second?generation ACE inhibitor, lisinopril (Diroton), on central and peripheral hemodynamics in patients with dilated cardiomyopathy (DCMP). In total, 39 persons with DCMP and chronic heart failure (CHF), aged 35–55 years, were examined. Diroton dose was titrated from low (2,5 mg/d) to high (10 mg/d). The treatment lasted for 12 months. Longterm Diroton therapy, as a part of complex pharmaceutical treatment, was associated with significant improvement in total and regional hemodynamics in DCMP patients: left ventricular ejection fraction increased, dilated myocardium volumes and sizes reduced, together with reduction in temporal rheography parameters and increase in velocity ones. Diroton therapy also improved clinical course of CHF and circadian blood pressure profile.

The aim of the study was to assess the effectiveness of antihypertensive therapy in two groups of patients with arterial hypertension (AH) and ischemic stroke. The length of the follow?up was 10,7±3,1 months. Fifty?six participants received quadropril (spirapril; 3 mg/d), and 53 ? indapamide (1,5 mg/d) and enalapril (10?20 mg/d). The dynamics of recurrent acute cerebral ischemia, blood pressure (BP) level (ambulatory control and 24?hour monitoring), extra? and intracranial cerebral blood flow (Doppler ultrasound) was assessed. Long?term quadropril therapy was associated with stable BP control and reduced number of recurrent strokes. Quadropril was effective for BP control in AH patients after ischemic stroke.

Aim: To study therapeutic effects of eprosartan on intravascular platelet activity in patients with arterial hypertension (AH) and metabolic syndrome (MS). Material and methods: In total, 32 participants received eprosartan (600 mg/d) for 4 months. Dynamics of lipid peroxidation in plasma and platelets, antioxidant potential of blood serum and platelets, intravascular platelet activity were assessed. The data were analyzed using Student’s t test. Results: In individuals with AH and MS, eprosartan therapy reduced lipid peroxidation and optimized intravascular platelet activity. Long?term eprosartan treatment could strengthen this beneficial effect. Conclusion. To decrease body weight in persons with AH and MS, eprosartan should be combined with non?pharmaceutical methods.

To assess the effectiveness of pre-hospital beta-blocker therapy in patients with acute coronary syndrome (ACS), 76 individuals with Q-wave myocardial infarction (Q-MI), and 62 persons with non-Q wave MI (non-Q-MI) were examined. Q-IM patients received aspirin, streptokinase, heparin, beta-blocker, and enalapril. They were divided into two groups, according to reperfusion status after thrombolysis (TL): Group I (reperfusion), Group II (no reperfusion). Each group was divided into subgroups, by the time of beta-blocker administration: subgroups Ia and IIa – pre-hospital administration, Ib and IIb – hospital treatment. Patients with non-Q-IM (Group III) were also divided into subgroups: IIIa – pre-hospital beta-blocker administration, IIIb – hospital beta-blocker treatment. Early (pre-hospital) beta-blocker therapy was associated with reduced area of myocardial necrosis, improved systolic and diastolic function, left ventricular geometry and clinical prognosis in MI patients.

As a part of a randomized clinical trial, the potential of patients’ education and monitoring by ambulatory therapeutists for improving pharmaceutical prevention and treatment effectiveness in Type 2 diabetes mellitus (DM-2) was evaluated. After 12 months, patients’ compliance and lipid level control improved significantly, as well as selfrated health and quality of life.

The study aimed at assessing atherosclerosis risk factors in women with early (<65 years) development of coronary heart disease (CHD). This case?control study included 167 climacteric women with stable effort angina and 167 CHD-free females (controls). Anthropometry and lipid profile parameters, rates of arterial hypertension (AH), chronic heart failure, stroke, and depression were assessed. CHD was associated with higher rates of AH, abdominal obesity, Type 2 diabetes mellitus, depression, knee osteoarthrosis, low level of high-density lipoprotein cholesterol, and more severe climacteric syndrome. Women with CHD had higher odds of stroke and longterm disability. Percentage of females with higher education was greater in the controls. Conclusion: Early CHD development in women was associated with multiple atherosclerosis risk factors.

In experiments with longitudinal stripes of cow renal artery, serum taken from healthy people and patients with Stage II arterial hypertension (AH), in titrations 1:100, 1:500, 1:1000, and 1:10000, did not influence tonotropic, alpha-drenoreceptor (AR) activating effect of adrenaline (10–6 g/ml). In titration 1:50, this effect was enhanced, due to serum alpha-adrenosensitizing activity. In Stage III AH, female serum did not affect tonotropic effect of adrenaline, and male serum reduced it in titrations 1:50, 1:100, and 1:1000, due to alpha-adrenoblocking activity. Therefore, 1) serum of cormotensive people and patients with Stage II AH could contain endogenous sensitizer of alpha-AR (ESAAR), and in Stage III AH its level might be reduced; 2) serum of males with Stage III AH could contain endogenous blocker of alpha?AR (EBAAR). The nature of ASAAR and EBAAR and their role in AH pathogenesis is discussed.