Until the present moment, the combination of arterial hypertension (AH) and acid-peptic disease (APD) has been understudied. The aim of this study was to assess the circadian profile of blood pressure (BP) in patients with AH and APD. In total, the study included 42 men, aged 20-57 years, with a combination of AH and APD. The comparison group included 24 patients with isolated AH. All participants underwent BP monitoring (Kardiotekhnika-04-AD device). The diagnoses of duodenal ulcer (DU) and gastro-oesophageal reflux disease (GERD) were verified with fibrogastroduodenoscopy. The patients with isolated AH had significantly greater hypertensive load (higher mean BP levels and BP load indices), compared to the individuals with AH and APD. These results point to more severe clinical course of AH and higher complication risk in the former group, compared to the patients with a combination of AH and APD.

In total, 40 patients, aged 19–28 years, with high normal blood pressure, HNBP (classification by the Society of Cardiology of the Russian Federation, 2008) were examined. The analysed parameters of 24-hour blood pressure monitoring (BPM) included mean 24-hour BP levels, time index, 24-hour index, amplitude and rate of the morning BP surge, BP variability, and arteriolar tone. Over 50% of the young people with HNBP demonstrated an increase in vascular tone, time index, BP variability, morning surge rate, and the percentage of non-dippers. In participants with normal or decreased arteriolar tone, the values of time index, BP variability, morning surge rate and mean 24 BP were significantly lower. Therefore, high BP pathogenesis could be different among young people with HNBP: in those with high vascular tone, it is related to vasoconstriction, while in those with normal or reduced vascular tone, it might be due to disturbed autonomic regulation and autonomic vascular dystonia.

To indentify the predictors of atrial fibrillation (AF) in patients with implanted artificial pacemakers (IPM), 65 such patients were followed up for 6 months. The AF group included 18 (27,7%) patients, while the comparison group consisted of 47 AF-free individuals. AF risk markers included increased maximal length and dispersion of P wave at electrocardiography, as well as increased P wave dispersion (by 13,9%) during the follow-up. In addition, volume, but not linear, characteristics of left atrium (LA) were 1,44-1,77 times greater in AF patients than in AF-free participants. During the follow-up period, linear LA parameters increased regardless of AF (by 19.8% and 14,8%, respectively), while AF volume significantly increased in AF individuals exclusively, which pointed to structural LA remodelling, and not only LA dilatation.

In 28 patients with intraventricular block and coronary heart disease (CHD), as well as in 20 professional ex-athletes with impaired intraventricular conductivity, corrected QT interval dispersion at maximal and minimal heart rate (HR) was assessed, based on the Holter ECG monitoring data. In both groups, absolute and corrected QT interval dispersion at minimal HR was similar and within minimally pathological range. For maximal HR, absolute and corrected QT interval dispersion increased by 21,3%, comparing to baseline, and reached moderately pathological range in CHD patients. In the other group, absolute and corrected QT interval dispersion decreased by 22,6%, compared to baseline, and reached non-pathological range.

In total, 316 patients after Q wave myocardial infarction (Q-MI) were randomised into 3 groups. For 6 months after discharge, the control group (n=103) received standard therapy (aspirin, enalapril, metoprolol, simvastatin). Group 1 (n=107) also received trimetazidine, and Group 2 (n=106) was administered ramipril, carvedilol, and trimetazidine. At baseline, 6 months and 2 years later, 24-hour Holter ECG monitoring was performed. The combination of ramipril, carvedilol, and trimetazidine (Group 2) was the most effective in prevention of pain and painless episodes of myocardial ischemia, as well as in reduction of supraventricular and ventricular extrasystolia incidence. The combination of enalapril, metoprolol, and trimetazidine (Group 1) was less effective than Group 2 treatment, but more effective than the therapy in the control group (enalapril, metoprolol, and standard therapy, without trimetazidine treatment).

The study included 60 patients, aged 45-65 years, with metabolic syndrome (MS), Functional Class II-III chronic heart failure (CHF), and recent myocardial infarction (MI). The participants were randomised into 2 groups (n=30 in each). The main group received standard CHF therapy and Mexicor (0,4 g/d). The follow-up lasted for 12 weeks. In MS patients, adding a cytoprotector Mexicor to complex CHF treatment was associated with CHF FC reduction, increased exercise capacity, and greater anti-anginal and anti-ischemic effects. As a part of combined CHF therapy, Mexicor facilitated myocardial remodelling regression, also improving left ventricular diastolic function and autonomic cardiac regulation. In patients with CHF and MS, Mexicor therapy improved lipid and carbohydrate metabolism, reduced insulin resistance and chronic inflammation.

In total, 54 patients, aged 42-65 years, with Stage II arterial hypertension (AH) were examined. At baseline and 16 weeks after the treatment phase, 24-hour blood pressure monitoring (BPM) and Doppler echocardiography were performed. The patients were randomised into 2 groups: Group 1 received combined therapy with indapamide and verapamil retard, while Group 2 was administered indapamide and amlodipine. Circadian BP rhythm was normalised in 82,8% and 76,0% of the patients from Groups 1 and 2, respectively. In Group 1, combined therapy was more effective among patients with Type I left ventricular diastolic dysfunction (LVDD), non-dipper circadian BP profile, and hyperkinetic circulation type. In Group 2, the therapy was more effective among participants with Type II-III LVDD and hypokinetic circulation type.

The study aimed at the assessment of broncholytic therapy effects on supraventricular arrhythmia structure and highdefinition ECG characteristics of atrial complex among patients with chronic obstructive pulmonary disease (COPD). In total, 144 COPD patients and 35 controls underwent 24-hour ECG monitoring and high-definition ECG with time and spectral mapping of atrial complex. Theophylline and seretide therapy resulted in reduced supraventricular arrhythmia incidence among patients with mild to moderate COPD. Among participants with severe COPD, theophylline therapy was associated with increased mean number of supraventricular extrasystoles. Seretide therapy in both groups and theophylline therapy in patients with moderate COPD demonstrated beneficial effects on high-definition ECG parameters of atrial complex, as well as spectral and time mapping characteristics. Therefore, seretide could be a better broncholytic choice in patients with severe COPD and supraventricular arrhythmias.

This multicenter, double-blind, parallel-group study compared the effects of three dihydropyridine calcium channel blockers (lercanidipine, felodipine, and nifedipine gastrointestinal therapeutic system, GITS) on blood pressure and heart rate in 250 patients with mild to moderate hypertension (diastolic blood pressure ≥95 mm Hg and ≤109 mm Hg). Patients were randomized to 4 weeks of treatment with once-daily doses of lercanidipine 10 mg, felodipine 10 mg, or nifedipine GITS 30 mg. After 4 weeks of treatment, the dose was doubled in nonresponding patients. At 8 weeks, no significant differences in blood pressure were observed among the three groups. Increases in heart rate in all three groups induced by stressful conditions before and after treatment were not exacerbated during active treatment. The incidence of adverse drug reactions was lower in the lercanidipine and nifedipine groups than in the felodipine group (р<0,05); in particular, the incidence of edema for lercanidipine was 5,5% vs. 13% for felodipine and 6,6% for nifedipine.

Acute myocardial infarction (AMI) is the leading cause of mortality in the most countries, including the Russian Federation. AMI is caused by rupture or erosion of atherosclerotic plaque, followed by occlusive coronary thrombosis. Thrombolytic therapy (TLT) is one of the most widely used and accessible pharmaceutical methods for treating recent thrombosis-related coronary occlusion. Many international multi-centre randomized studies, including tens of thousands participants worldwide, have demonstrated high effectiveness and excellent success rates for systemic TLT in AMI patients. The importance of early TLT has been emphasized (GISSI I, 1986; ISIS 2, 1988; AIMS, 1990; GUSTO I8 III, 1993–1997). Early TLT has beneficial effects on myocardial electric stability and prevents hemodynamic complications and remodelling, therefore, reducing the risk of disability and mortality.

Taurine (T) was first noted as beneficial for stroke and cardiovascular diseases (CVD) prevention in genetic rat models, stroke-prone spontaneously hypertensive rats (SHRSP). The preventive mechanisms of T were ascribed to sympathetic modulation for reducing blood pressure (BP) and antiinflammatory action. Recent epidemiological surveys revealed the involvement of inflammatory mediators in the pathogenesis of stroke and also atherosclerosis for which T was proven to be effective experimentally. Arterio-lipidosis prone rats, a substrain of SHRSP selectively bred for higher reactive hypercholesterolemia, quickly develop not only arterial fat deposition but also fatty liver which could be attenuated by dietary T supplementation. CARDIAC (CVD and Alimentary Comparison) Study was a WHO-coordinated multi-center epidemiological survey on diets and CVD risks and mortalities in 61 populations. Twenty-four-hour urinary (24U) T was inversely related significantly with coronary heart disease mortality. Higher 24U-T excreters had significantly lower body mass index, systolic and diastolic BP, total cholesterol (T-Cho), and atherogenic index (AI: T-Cho/high density lipoprotein-cholesterol) than lower T excreters. T effects on CVD risks were intensified in individuals whose 24U-T and -magnesium (M) excretions were higher. Furthermore, higher Na excreters with higher heart rate whose BP were significantly higher than those with lower heart rate were divided into two groups by the mean of 24U-T, high and low T excreters. Since the former showed significantly lower BP than the latter, T may beneficially affect salt-sensitive BP rise. Included among the typical 61 populations, were Guiyang, China or St. John’s, Newfoundland, Canada, in which the means of both 24U-T and -M were high or low, respectively. The former and the latter had low and high CVD risks, respectively. Australian Aboriginals living at the coastal area in Victoria were supposed to eat T- and M-rich bush and sea foods and be free from CVD 200 years ago, but they presently have nearly the highest CVD risks indicating that T- and/or M-containing seafood, vegetables, fruits, nuts, milk, etc, similar to prehistoric hunters’ and gatherers’ food should be good for CVD prevention. The preventive effects of T, good for health and longevity, first noted experimentally, were also proven epidemiologically in humans.

Worldwide, obesity prevalence is reaching the level of epidemics. It has been demonstrated that the risk of cardiovascular disease development and progression is very high in obese patients. The main mechanism, underlying negative effects of adipose tissue on cardiovascular system, is its hormonal activity. Leptin, a hormone produced by white adipocytes, plays an important part in endothelial dysfunction, thrombogenesis, and atherogenesis. In obesity, the concentration of adiponectin, which has anti-atherogenic, anti-inflammatory, and insulin-sensitizing effects, is substantially decreased. Correction of such modifiable risk factors as hyperleptinemia and hypoadiponectinemia is one of the methods for cardiovascular prevention.

Endothelial dysfunction is the common link between cardiovascular disease risk factors and the earliest event in the cascade of incidents that results in target organ damage. Angiotensin II, the terminal pressor effector arm of the renin-angiotensin-aldosterone system, increases blood pressure (BP) by vasoconstriction and sodium and fluid retention, and has a prooxidative action that induces endothelial dysfunction and contributes to vascular remodeling. Angiotensin receptor blockers (ARBs) reduce BP and morbidity and mortality in patients with hypertension, ventricular hypertrophy, diabetes mellitus, and renal disease. Olmesartan medoxomil is a long-acting, well-tolerated, effective ARB that prevents or reverses endothelial dysfunction in animal models of atherosclerosis, hypertension, diabetes, nephropathy, and retinopathy. Olmesartan medoxomil, a prodrug of olmesartan approved for the treatment of hypertension, has been shown to ameliorate endothelial dysfunction in patients with hypertension or diabetes. In randomized studies, the drug reduces vascular inflammation and the volume of large atherosclerotic plaques, increases the number of regenerative endothelial progenitor cells in the peripheral circulation, improves endotheliumdependent relaxation, and restores the normal resistance vessel morphology. Importantly, the impact of olmesartan medoxomil on endothelial dysfunction is thought to be independent of BP lowering.

Starting from the 1960s, thiazide diuretics have been widely used for arterial hypertension management. In prospective studies, their role in reducing the risk of cardiovascular events was demonstrated. A thiazide-like diuretic indapamide is used in low doses, and, in contrast to thiazide diuretics, affects NaCl reabsorption to a lesser extent; therefore, it is linked to minimal Ka excretion. Indapamide acts as a peripheral vasodilator due to calcium channel blockade and increased synthesis of PgE2 . Several Russian studies demonstrated that Indap has good antihypertensive, cardio- and nephroprotective effectiveness, and is metabolically neutral. In a comparative trial, Indap was biologically and therapeutically equivalent to both forms of the original medication. This agent could be used as monotherapy, or in combination with medications of other classes.