[The comparative characteristics of disease prevalence and the structure of mortality in women of reproductive age]. / Sravnitel'naia kharakteristika rasprostranennosti nekotorykh zabolevanii i struktura smertnosti zhenshchin reproduktivnogo vozrasta.

Incidence rate of some diseases and mortality have been analyzed basing on the examination of 714 females aged 18-50 and 176 fatal outcomes in 23-82-year-old females. The disease prevalence and death rate showed the trend to an increase with growing number of deliveries. Multiparas die more frequently of cardiovascular diseases the risk of which proved the highest in the group of multiparas over 45 years of age.

[Effect of mevinolin and glycyrrhizinic acid on cholesterol and bile acid metabolism in cultured rabbit hepatocytes]. / Vliianie mevinolina i glitsirrizinovoi kisloty na metabolizm kholesterina i zhelchnykh kislot v kul'tiviruemykh gepatotsitakh krolika.

A comparison of effects of two hypocholesterolemic drugs--mevinolin and glycyrrhizinic acid, on cholesterol and bile acid metabolism in cultured rabbit hepatocytes has been carried out. The following parameters have been determined: i) cholesterol synthesis from [2-14C]acetate; ii) bile acid production from newly synthesized and [4-14C]-labeled HDL2 cholesterol, and, iii) total cholesterol efflux into the incubation medium Mevinolin (0.5 microgram/ml) inhibited [2-14C] acetate incorporation into cholesterol by more than 90%. Conversely, glycyrrhizinic acid did not influence cholesterol synthesis even when used at high (100 micrograms/ml) concentrations but stimulated the conversion of endogenous (by 37%) and exogenous (by 18%) cholesterol into bile acids and increased, in addition, the proportion of bile acids in the total sterol pool released from hepatocytes into the incubation medium. At the same time, mevinolin used at 0.5 microgram/ml decreased the bile acid production by endogenous (by 27%) and exogenous (by 40%) cholesterol. The data obtained suggest that glycyrrhizinic acid exerts hypocholesterolemic action by stimulation of cholesterol conversion into bile acids without any effect on cholesterol synthesis. As for mevinolin, it has a cholesterol-suppressing effect via a mechanism of cholesterol synthesis inhibition only.

[Clinical use of chloranolol (tobanum) in essential hypertension patients]. / Klinicheskoe primenenie khloranolola (tobanuma) u bol'nykh gipertonicheskoi bolezn'iu.

A clinical study of the efficiency of a new beta-blocker, chloranolol (Tobanum, Hungary), was carried out in 24 patients with second-stage essential hypertension. Central and intracardiac hemodynamics, left-ventricular myocardial function (echocardiography) and regional hemodynamics (occlusion plethysmography) were assessed in 14 patients before treatment and on days 10-15 and 25-30 of chloranolol administration. During the fourth or fifth week of chloranolol treatment, arterial BP diminished by 12/10% (p less than 0.01) owing to an 11.5% reduction in the cardiac index and a 15.7% reduction in heart rate (p less than 0.001), while the stroke index and total peripheral resistance showed no significant change. No basic changes in end diastolic and systolic left-ventricular size and volume, nor in the ejection fraction were seen during treatment. Myocardial contractility dropped by 9.8% (p less than 0.05), and intramyocardial tension, by 14% (p less than 0.001), while the thickness of the interventricular septum declined by 7% (p less than 0.001), and that of left-ventricular posterior wall, by 4.2% (p less than 0.005). Chloranolol treatment was particularly efficient in moderately hypertensive patients and also in some highly-hypertensive ones that had not responded to propranolol.

[Regression of left-ventricular myocardial hypertrophy in patients with hypertension during long-term treatment with beta-adrenergic blockaders]. / Regressiia gipertrofii miokarda levogo zheludochka u bol'nykh gipertonicheskoi bolezn'iu v protesesse dlitel'nogo lecheniia beta-adrenergicheskimi blokatorami.

Thirty-nine patients with second-stage essential hypertension were treated with Beta-adrenoblockers of different classes for 2.5 to 3 years. Two groups of patients were distinguished: 23 patients showing a regression of left-ventricular myocardial weight (group 1) and 16 patients without such developments (group 2). A significant decrease in arterial blood pressure (by 20-24%) and heart rate (by 15 to 18%) was recorded in both groups. Total peripheral resistance was changed insignificantly in group 1 and by 9.7% (p less than 0.05) in group 2. The end diastolic volume decreased by 5.4% (p less than 0.05) in group 1, and increased by 4.7% (p less than 0.05) in group 2. The end systolic volume decreased by 10.6% (p less than 0.05) in group 1 and increased by 5% (p greater than 0.1) in group 2. Myocardial contractility declined significantly in both groups (by 9.5% and 10.6%, respectively). Intramyocardial tension dropped by 13-20% (p less than 0.001) in both groups. Therefore, the regression of left-ventricular myocardial hypertrophy was shown to have a favorable effect on cardiac function.

[Condition of the tissue oxygen regime of patients with essential hypertension with different types of hemodynamics]. / Sostoianie kislorodnogo rezhima tkanei u bol'nykh gipertonicheskoi bolezn'iu s razlichnymi tipami gemodinamiki.

Systemic and regional hemodynamic parameters were investigated using echocardiography, venous-occlusion plethysomography, and tissue oxygen regimen was studied polargraphically, in 51 patients with essential hypertension. Tissue oxygen supply becomes increasingly inadequate as the disease progresses, as reflected in limited oxygen delivery to tissues, its reduced utilization, and smaller reserve capacities of oxygen transport at the microcirculatory level. In patients with hyperkinetic circulation, increased blood stroke volume was combined with a significant increase in baseline tissue oxygen tension and the capillary-to-tissue oxygen diffusion rate, while changes in the resistive vascular element were basically functional. Changes in regional hemodynamics and tissue oxygen supply were particularly severe in patients with hypokinetic circulation.

[Prolonged use of beta-blockers in patients with essential hypertension and different degrees of severity of left ventricular hypertrophy]. / Dlitel'noe primenenie beta-blokatorov u bol'nykh gipertonicheskoi bolezn'iu s razlichnoi stepen'iu vyrazhennosti gipertrofii levogo zheludochka.

The paper is concerned with analysis of the results of therapy with beta-blockers of different classes of 56 patients (over 2.5-3 yrs) with essential hypertension and analysis of the time course of the structural-functional states of the left ventricular myocardium with various degree of expression of left ventricular hypertrophy (LVH). The patients were divided into 3 groups: the 1st group--14 persons (the left ventricular myocardial mass/LVMM/up to 150 g); the 2nd group--19 persons (the LVMM up to 200 g); the 3rd group--23 persons (the LVMM over 200 g). Patients in all the groups showed a significant decrease in BP from 19/15 up to 26/22% (p less than 0.001), the cardiac index (CI) from 14.4 up to 18.5% (p less than 0.001), and HR from 16.5 to 19.1% (p less than 0.001). The stroke index (SI) did not change significantly. The total peripheral vascular resistance (TPVR) in all the groups showed a tendency to a decrease, in the 3rd group only it decreased significantly. In the patients of the 1st and 2nd groups end-systolic sizes (ESS) increased by 4.1 and 3.1% (p less than 0.05) and volumes (ESV) by 9.7 and 7.4% (p less than 0.05), and in the 3rd group a tendency to a decrease was observed. End-diastolic sizes and volumes in all the groups did not change significantly. The myocardial contractility index (VCF) decreased significantly in the 1st and 2nd groups of patients. The value of intramyocardial tension ("sigma max") decreased in all the groups from 15 to 20% (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

[Treatment of hypertension with the calcium antagonist korinfar and its combination with obzidan]. / Lechenie gipertonicheskoi bolezni antagonistom kal'tsiia korinfarom i ego sochetaniem s obzidanom.

A hypotensive effect of corinfar and its effect on the indices of the central and peripheral hemodynamics were studied in 50 patients with stage II hypertension. In 3 weeks BP was lowered at the expense of a considerable decrease in the total peripheral vascular resistance (TPVR) (by 29.6%) and regional vascular resistance (by 48%). It was accompanied by an increase in the peripheral blood flow (by 61%), a reflex activation of the sympathetic-adrenal system with an increase in heart rate and cardiac output (by 22%, p less than 0.001). An index of vein distensibility remained unchanged. The addition of propranolol removed signs of the sympathetic stimulation of the cardiac activity, improved vasodilatator tolerance, enhanced a hypotensive effect of corinfar causing a transient increase in TPVR and tension of the resistive vessels only. By the end of the 4th month of therapy these indices significantly decreased. A prolonged combined therapy with corinfar and propranolol resulted in a significant decrease in the resistance of resistive vessels in maximum vasodilatation characterizing the regression of arteriole structural changes. Besides there was a decrease in the wall thickness (p less than 0.01) and left ventricular myocardial mass (by 7.88 +/- 2.66 g, p less than 0.05) that was interpreted as a tendency to a decrease in a degree of hypertrophy of the left ventricle. The efficacy of corinfar therapy was higher in the patients with hypertension with a high initial tension of the peripheral vessels.

[Characteristics of left ventricular hypertrophy in patients with different forms of arterial hypertension based on echocardiographic data]. / Kharakteristika gipertrofii levogo zheludka u bol'nykh s razlichnymi formami arterial'noi gipertonii po dannym ékhokardiografii.

Echocardiographic investigation of 110 patients with different forms of stable arterial hypertension demonstrated a moderately close correlation between left-ventricular myocardial weight, and systolic and diastolic arterial blood pressure in patients with essential hypertension and chronic diffuse glomerulonephritis, and a weak correlation between left-ventricular myocardial weight and systolic pressure in patients with renovascular hypertension and chronic unilateral or predominantly unilateral pyelonephritis. Inadequate left-ventricular hypertrophy has similar incidence (15-20%) in patients with different forms of arterial hypertension, whereas excessive hypertrophy only occurs in patients with essential hypertension. The frequency of asymmetrical hypertrophy differs in the two groups.

[Evaluation of the effectiveness of the long-term treatment of hypertension patients. I. Changes in hemodynamics and myocardial function]. / Otsenka éffektivnosti dlitel'nogo lecheniia bol'nykh gipertonicheskoi bolezn'iu. I. Izmeneniia gemodinamiki i funktsional'nogo sostoianiia miokarda.

Altogether 106 patients with stage II essential hypertension (EH) were treated for a long time (up to 3 years) with beta-blockers belonging to different classes. In some cases beta-blockers were administered in combination with vasodilators and/or a diuretic. In 66 patients, prolonged continuous treatment led to an appreciable drop in blood pressure (BP) due to the reduction of both the cardiac index and the total peripheral vascular resistance (TPVR), particularly in patients with stage IIB essential hypertension treated with a cardioselective beta-blocker tenormine or an alpha- and beta-blocker trandate. These patients showed a significant decrease in intramyocardial tension, in the thickness of the walls and mass of the myocardium. Regression of left ventricle hypertrophy depended not only on the hemodynamic factors that determine the decrease in the load of the myocardium by the volume or pressure but also on the neurohumoral effects (mainly due to the reduced adrenergic stimulation during treatment with beta-blockers). In 40 patients with stage IIB EH treated occasionally, BP appeared to approach the initial level after 2.5-3 years. Furthermore, these patients manifested an increase in the TPVR. The myocardial mass significantly rose, mainly at the expense of the thickening of the ventricular septum.

[Ambulatory treatment of hypertension with the beta-blockader corgard (nadolol)]. / Ambulatornoe lechenie bol'nykh gipertonicheskoi bolezn'iu beta-blokatorom korgardom (nadololom).

Fifteen outpatients with stage II essential hypertension were treated with corgard, a non-cardioselective beta-blocker, for 12-15 months. Study (in 12 patients) of the shifts in the central and intracardiac hemodynamics (by EchoCG for 3-4 months) demonstrated that a 24-25% decrease in the blood pressure occurred at the expense of a significant reduction in the cardiac index (by 25.6%) and heart rate (by 29%). The stroke index did not undergo any significant changes. This was accompanied by a moderate increase of the total peripheral vascular resistance (by 7.4%, P less than 0.05). The intramyocardial tension decreased by 18%, the thickness of the interventricular septum by 7.1% (P less than 0.001), the myocardial mass dropped by 9.5% (P less than 0.001). The rate of the shortening of the circulatory fibers of the left ventricle myocardium decreased by 10% (P less than 0.01). The ejection, the degree of a change in the anteroposterior size or in the end systolic and end diastolic sizes remained unchanged. Thus, application of corgard can be regarded as fairly advantageous since this drug produces a long-acting effect. It can be administered once or twice a day, with dosage variations being insignificant. This circumstance facilitates the regimen of a long-term outpatient treatment.

[Therapeutic effect of the beta-adrenergic receptor blocker corgard (nadolol) and its effect on hemodynamics in hypertensive patients]. / Lechebnyi éffekt blokatora beta-adrenergicheskikh retseptorov korgarda (nadolola) i ego vliianie na gemodinamiku u bol'nykh gipertonicheskoi bolezn'iu.

The therapeutic effect of the non-cardioselective beta-blocker corgard (nadolol) was examined in 40 patients with stage II essential hypertension. In 22 of those, central, intracardiac and regional hemodynamics were measured echocardiographically and rheographically after 2 and 4 weeks of treatment. Blood pressure dropped significantly by days 8-13 of treatment, as a result of cardiac index reduction mainly due to decreased heart rate. At the same time, a moderate yet significant rise in total peripheral vascular resistance was noted. Intramyocardial tension decreased, as did the thickness of the left-ventricular posterior wall and interventricular septum, which caused a significant (6.74%) reduction in myocardial weight.

[Therapeutic effect of the cardioselective beta-blocking agent tenormin and its action on the indices of systemic, intracardiac and regional hemodynamics in patients with hypertension]. / Lechebnyi éffekt kardioselektivnogo beta-blokatora tenormina i ego vliianie na pokazateli tsentral'noi, vnutriserdechnoi i regionarnoi gemodinamiki u bol'nykh gipertonicheskoi bolezn'iu.

Cardioselective beta-blocking agent tenormin (atenolol) was used in 55 patients with essential hypertension, Stage II; in 20 of those, central, intracardiac and regional hemodynamics were assessed echocardiographically and rheographically. Tenormin produced a pronounced hypotensive effect within 2-4 weeks of treatment (BP decreasing by 26.8/22.8%). A significant decrease was noted in cardiac index (by 26.8%), heart rate (by 24%), intramyocardial tension (by 21.9%), the myocardial circular fibre shortening rate (by 6.5%), left-ventricular myocardial wall thickness and weight (by 4.5%). Total vascular peripheral resistance did not change significantly (it dropped in half of the patients). Stroke index, output fraction and left-ventricular size remained unchanged. Cerebral and femoral arterial tone also decreased. Tenormin was effective in 5 patients with hypertension combined with bronchial asthma. Owing to its prolonged action, tenormin can be administered once or twice daily, a factor that facilitates considerably prolonged out-patient treatment.

[Comparative evaluation of the therapeutic effect of various classes of beta-blockaders in patients with hypertension]. / Sravnitel'naia otsenka lechebnogo éffekta beta-blokatorov razlichnykh klassov u bol'nykh gipertonicheskoi bolezn'iu.

A complex study of changes of hemodynamics and myocardial performance was conducted while treating 215 hypertensive patients with obsidan (propranolol), corgard, a cardioselective beta-blocker tenormine and alpha- and beta-blocker trandate. Different hypotensive efficiency and varying hemodynamic mechanisms of its action were found. Obsidan and corgard were mainly efficient in moderate hypertension and marked hypersympathicotonia. Tenormine and trandate produce the most marked hypotensive effect (due to reduction in the vascular tone). The signs of increase in venous blood return to the heart during trandate and obsidan therapy and decrease in venous return after long-term tenormine therapy were established. Myocardial contractility indices decreased after obsidan therapy to the more extent than after corgard and tenormine, and they did not change after trandate. The possibility of myocardial hypertrophy regression was shown (especially in the long-term treatment with tenormine and trandate). A reduction in intramyocardial tension has been stated to depend mainly on hemodynamic factors (reduction in volume or pressure overload on the myocardium) whereas the diminution of the myocardial mass also depends on neurohumoral effects.

[Therapeutic effect of trandat, an alpha- and beta-adrenergic receptor blockader, and its effect on central, regional and intracardiac hemodynamics]. / Lechebnyi éffekt trandata-blokatora al'fa- i beta-adrenergicheskikh retseptorov i ego vliianie na tsentral'nuiu, regionarnuiu i vnutriserdechnuiu gemodinamiku.

A study of the effect of labetalol (trandat) was carried out in 75 arterial hypertensive patients. The central, regional, and intracardial hemodynamics were studied in 40 of them by echocardiography and rheography. A 25% decrease in BP and subjective improvement were observed on the 1-2 week of treatment. Total peripheral vascular resistance decreased by 22.4%, heart rate - 7%, intramyocardial tension - 21%, left ventricular wall thickness and myocardial mass - 2.5%; brain and crural vascular tone also decreased. Cardiac index, ejection fraction, and left ventricular circumferential shortening velocity were not changed. In fourteen patients there was observed a significant decrease in the plasma renin activity. A number of advantages of trandat effect was found as compared to the effect of propranolol: blood pressure decreased at the account of the total peripheral vascular resistance diminution without suppression of myocardial contractility; the regional blood circulation was improved.