[State of cerebral circulation in patients with essential arterial hypertension].

In order to evaluate the volumetric flow rate of the blood in the major extracranial arteries, as well as to assess intracranial haemodynamics in patients presenting with isolated arterial hypertension and those with haemodynamically insignificant pathologies of the "CA" the authors analysed the findings obtained in a total of 159 patients (71 males and 88 females) who were diagnosed with mild, moderate and severe arterial hypertension. The average age of the patients amounted to 59 +/- 12 years. Studying the thickness of the intima-medial complex of the common carotid artery in both isolated arterial hypertension (AH) andAH combined with atherosclerotic alterations in the CA demonstrated its thickening, which was more evident in a combination of atherosclerosis with AH. The study revealed a decrease in the volumetric flow rate ofthe blood in all extracranial vessels, as well as that of the total volumetric flow rate in the group ofpatients with isolated AH and especially those with a combination of AH and atherosclerosis. The patients sufferingfrom both isolated AH and a combination of AH with pathological alterations of/in the carotid arteries demonstrated alterations in the flow-rate indices and an increase in the indices of the peripheral resistance in the arteries of the circle of Willis, which were mostly pronounced in those with a prolonged history of AH. A trend towards a decrease in the indices of the flow-rate of the bloodstream and an increase in the indices of the peripheral vascular resistance in hypertensive patients is determined by structural alterations in the vascular wall of the extracranial arteries on the one hand, and by the development of hypertensive microangiopathy, on the other.

[Effect of atherogenic risk factors on the state of complex intima-media of common carotid artery]. / Vliianie riada aterogennykh faktorov riska na sostoianie kompleksa intima-mediia obshchei sonnoi arterii.

AIM: To elucidate relationship between presence of atherogenic risk factors (dyslipidemia, hypertension, smoking, etc.) and common carotid artery intima-media thickness. MATERIAL AND METHODS: Color duplex carotid artery scanning and determination of blood lipids, lipo- and apolipoproteins were carried out in 160 patients aged 34-73 (mean 57.4+/-8.2) years. RESULTS: Dyslipidemia, hypertension (diastolic blood pressure > or = 95 mm Hg), smoking and intima-media thickness > 1 mm were present in 57, 49, 54 and 65% of patients, respectively. Intima-media thickness increased with age and in the presence of hypercholesterolemia, hypertension and smoking. Significant (p<0.05) correlations existed between intima-media thickness and levels of total cholesterol (r=0.512), triglycerides (r=0.411), apolipoprotein B (r=0.497), high density lipoprotein cholesterol (r=-0.404), apolipoprotein-A1 (r=-0.386), duration of hypertension (r=0.488). CONCLUSION: Ultrasound study of intima-media thickness allowed to assess harmful effect of various atherogenic risk factors (mechanical - hypertension, biochemical - dyslipidemia, toxic - smoking) on the state of arterial wall.

Prevalence of ischaemic heart disease and of various electrocardiographic changes according to findings of the cooperative Moscow-Kaunas-Minsk study.

In the cooperative study of multifactorial prevention of ischaemic heart disease (IHD), conducted in Moscow, Kaunas and Minsk, the authors investigated and compared the prevalence of IHD, its various forms, ECG changes and the awareness of the IHD patients that they were affected by this disease. Preventive examination of the male population in the 40 to 59 years age group revealed the presence of IHD in 14.8% in Moscow, 10.7% in Kaunas and 14.1% in Minsk. In the male population in Moscow IHD has a more severe course with the prevalence of painful forms, whereas in Kaunas there occur in more than 50% of the patients and in Minsk in 49% painless forms of IHD. Myocardial infarction occurs in Moscow more frequently (3.7%) than in Minsk (3.1%) and in Kaunas (2.5%), and is in Moscow in a higher percentage of cases associated with signs of pronounced cicatricial changes in the myocardium on the ECG. Angina pectoris of effort occurred among persons without MI in Kaunas in 2.4%, in Minsk twice as frequently (4.8%) and in Moscow nearly three times as frequently (6.8%). Of the persons in whom examination established the presence of IHD or angina pectoris of effort, every third in Moscow and every second in Kaunas and Minsk was not aware of their disease.

[Bicycle ergometry test results in persons with ischemic heart disease detected in mass screening]. / Rezul'taty veloérgometricheskoi proby u lits s ishemicheskoi bolezn'iu serdtsa, vyiavlennoi pri massovom obsledovanii.

Bicycle ergometry in 40-59 year-old male patients with coronary heart disease, identified during mass prophylactic examination on the basis of epidemiological criteria, has shown that in patients with angina pectoris of effort and no myocardial infarction in history positive exercise tests are observed in 20,8% of cases, while in patients with painless CHD forms positive results are observed in 15.4% of cases. Positive exercise tests are the most often in patients with daily anginal attacks and in those with ST depression and flat negative T waves.

[Detection of ischemic heart disease during the prophylactic examination of the 40- to 59-year-old male population a Moscow district]. / Vyiavlenie ishemicheskoi bolezni serdtsa pri profilkaticheskom obsledovanii muzhskogo naseleniia 40--59-letnogo vozrasta odnogo iz raionou Moskvy.

The authors discuss the information on the prevalence of the various forms of ischemic heart disease, the frequency of the risk factors among them, the patients' knowledge of the fact that they have ischemic heart disease and application for medical aid, and the frequency of angina pectoris attacks in patients with myocardial infarction and in persons not suffering from this disease. The results of the survey showed that it is necessary to conduct purposeful examinations and organize dispensary follow-up of patients with ischemic heart disease with due consideration for the severity of the clinical manifestations and the presence of risk factors.

Standardized Minnesota coding of electrocardiographic findings for purposes of cooperative research on ischaemic heart disease.

For purposes of cooperative research on multifactorial prevention of ischaemic heart disease, a standardization system was elaborated in the USSR for classification of ECG findings according to the Minnesota code. The system includes instruction about the coding rules, experimental coding, analysis of faulty codings, and finally a control test consisting in encoding several series of 200 ECG findings each. For assessing the encoder's qualification the criterion was accepted of less than 20% cases of discordance with the standard code of "ischaemic" ECG changes. It was found that after the initial instructive course it was necessary to gain experience with encoding at least 1 000 ECG to qualify the candidate for the specified expert level. The necessity is emphasized of continual surveillance of the quality of ECG classification by the encoders in different centres, and the possibility of reaching a satisfactory level of unification is declared.