[Clinical value of brain natriuretic peptide level in patients with atrial fibrillation].

UNLABELLED: PURPOSE of this investigation was to study correlation between brain natriuretic peptide (BNP), extent of cardiac abnormalities, and six minute walk test (6-MWT) in order to asses diagnostic value of BNP in patients with trial fibrillation (F), heart failure (HF) and preserved systolic function. MATERIAL AND METHODS: Sixty five patients with history of hypertension, permanent F, and shortness of breath in absence of signs of congestive hemodynamics were included into this study. RESULTS: Concentration of BNP in serum n the day of inclusion was significantly inversely related to results of 6-MWT, and positively related to left atrial dilation, to hospitalizations due to cardiovascular causes. CONCLUSION: Measurement of BNP concentration in patients with AF allows to diagnose HF at early stages and to predict cardiovascular complications.

[Predictive value C-reactive protein assessment level in women with arterial hypertension].

Classic modifiable cardiovascular risk factors, such as blood pressure and dyslipidaemia are incorporated into clinical practice to estimate the 10-year risk of fatal cardiovascular disease (CVD): the SCORE project. To improve CVD risk estimation in women we compared predictive value of two models: risk chart based on the SCORE study and the Reynolds Risk Score in 134 women with hypertension to optimise risk stratification and preventive strategies in high-risk individuals. We concluded that Reynolds Risk model causes clinically relevant changes in risk category classification compared to risk chart SCORE and improves risk stratification. Addition of C-reactive protein to Reynolds Risk model improves it predictive value regardless of other risk factors. C-reactive protein is a strong marker of atherosclerosis, can be useful in women for risk stratification in daily practice regardless of risk prediction model.

[Treatment of arterial hypertension in patients with benign prostatic hyperplasia]. / Lechenie artrerial'noi gipertenzii u lits s dobrokachestvennoi giperplaziei predstatel'noi zhelezy.

Arterial hypertension (AH) is encounted in 20-30% of patients with benign prostatic hyperplasia (BPH). Alpha1-adrenoblockers have limited application in such patients and should be used as a first-line therapy only in those BPH patients who already receive them for BPH. In other cases AH is managed with thiaside diuretics, beta-adrenoblockers, ACE inhibitors or calcium antagonists. A drug of choice for correction of urination disorders in BPH hypertensive patients is alpha1A-adrenoblocker tamsulozin.

[The hypotensive effect and tolerance of valsartan (Diovan) in hypertension in a general clinical practice]. / Gipotenzivnyi éffekt i perenosimost' valsartana (diovan) pri gipertonicheskoi bolezni v obshchei klinicheskoi praktike.

AIM: An assessment of a hypotensive effect and tolerance of valsartan. MATERIALS AND METHODS: In 20 patients with mild and moderate blood hypertension (BH) the latter was registered sphygmomanometrically by N. S. Korotkov and by 24-h monitoring. The initial valsartan dose 80 mg/day was raised to a single daily dose 160 mg in 4 weeks in the absence of adequate correction in tolerance. RESULTS: The hypotensive effect of Diovan in a dose 80 mg/day was satisfactory or good in 80% of patients. 15% of patients needed elevation of the dose to 160 mg/day. A complete resistance occurred in 1 patient. There were neither unwanted effects nor biochemical evidence of clinically significant renal or hepatic dysfunction due to valsartan. In stable BH correction, the rate of residual hypotensive effect reached 77.4% and 74.5% for systolic and diastolic BP, respectively. CONCLUSION: High effectiveness, good tolerance and safety of valsartan in single doses 80-160 mg/day allow to recommend it in monotherapy of mild and moderate hypertension.

[Fosinorm in the treatment of essential hypertension with a metabolic syndrome]. / Fozinorm pri lechenii éssentsial'noi gipertonicheskoi bolezni s metabolicheskim sindromom.

The authors made an open-comparative trial of fosinopril (Fosinorm) efficacy and tolerability in 20 patients (9 males and 11 females) with stage II mild and moderate essential hypertension accompanied with disturbed glucose tolerance and dyslipidemia. Fosinorm was given in a dose 10 - 20 mg/day under 24-h monitoring of blood pressure. Diastolic pressure returned to normal in 19 (95%) patients, one patient showed a good hypotensive response. The mean 24-h fall in the systolic and diastolic pressure was significant and made up for systolic pressure 7.5% (9.2% and 9.2%), respectively. Fosinorm had a minimal effect on carbohydrate metabolism, total cholesterol, serum triglycerides. The conclusion is made that Fosinorm is a highly effective antihypertensive drug positively influencing 24-h profile of blood pressure in the absence of negative action on carbohydrate and lipid metabolism.

[The hypolipidemic effect of and tolerance for Lescol in treating hypercholesterolemia in hypertension patients (an analysis of the data from a multicenter study)]. / Gipolipidemicheskii éffekt i perenosimost' leskola pri lechenii giperkholesterinemii u bol'nykh gipertoniei (analiz dannykh mnogotsentrovogo issledovaniia).

Hypertensive patients with hyperlipidemia are at high risk to develop coronary heart disease (CHD). Chemotherapeutic correction of hyperlipidemia seems most reliable modality to prevent CHD. Hypolipidemic effect and tolerance of leskol (fluvastatin) in dietotherapy-resistant hypercholesterolemia were studied in 74 patients with essential hypertension treated with hypotensive drugs. The patients were included in a multicenter trial. A 12-week course reduced total cholesterol level under 6.2 mmol/l in 59% of the patients, under 5.2 mmol/l in 29% of them. LDLP cholesterol lowered to 3.5% in 34% of the patients. Mean apo B diminished by 23%. There was a 27% decrease in the proportion of atherogenic fraction apo B to antiatherogenic fraction of transport proteins apo A-I. Leskol is well tolerated and effective against hypercholesterolemia, it is safe in relation to side effects and blood biochemistry.

[Hypertension, diabetes mellitus, atherosclerosis: clinical manifestations of metabolic syndrome X. Prospects of pharmacological treatment]. / Gipertoniia, sakharnyi diabet, ateroskleroz--klinicheskie proiavleniia metabolicheskogo sindroma X. Perspektivy farmakologicheskoi korrektsii.

Currently available data and clinical observations which suggest that there is a pathogenetic relationship between hypertension, diabetes mellitus, and atherosclerosis have provided a concept of the X syndrome, by which hypertensive patients, mainly males, have impaired insulin tolerance along with hyperinsulinemia and concurrent atherogenic disorders of lipid metabolism. The paper discussed the specific pathogenetic mechanisms, clinical manifestations, and prospects for drug correction of the metabolic syndrome. The treatment of arterial hypertension with the calcium antagonist Lomir has indicated there are no negative changes as a control of non-insulin-dependent diabetes mellitus in the presence of effective correction of arterial hypertension and atherogenic dyslipidemias. With the monotherapy of essential hypertension concurrent with hypercholesterolemia with the alpha 1-adrenoblocker Doxazosin, in addition to the agent's high antihypertensive effects, the authors noted its favourable action on lipid spectral parameters and platelet functional activity. There is abundant evidence for the use of specific hypolipidemic agents in patients with essential hypertensive refractory to current antihypertensive drugs. The data obtained with the use of Lescol (fluvastatin) in patients with hypertensive disease and hypercholesterolemia suggest that by substantially reducing the levels of total cholesterol, triglycerides, low density lipoprotein cholesterol and its transport protein apo B does not deteriorate the quality of correction of arterial hypertension in this group of patients.

[The regression of the structural-functional changes in the hypertrophic left ventricle during the long-term correction of the arterial pressure with Inhibace (cilazapril)]. / Regressiia strukturno-funktsional'nykh izmenenii gipertrofirovannogo levogo zheludochka pri dlitel'noi korrektsii arterial'nogo davleniia ingibeisom (tsilazprilom).

The regression of structural and functional alterations in the hypertrophic left ventricle was measured in the course of long-term correction of arterial pressure with a new inhibitor of angiotensin-converting enzyme ingibeis (chilasapril) in 23 patients with essential hypertension stage II-III. The results were for the most part obtained at echocardiography providing basic hemodynamic parameters and those of left ventricular diastolic function. Adaptability of the hypertrophic myocardium in response to physical loading was studied dynamically under isometric exercise test. The findings proved high efficacy of chilasapril in monotherapy of arterial hypertension. Long-term (6 months) therapy of left ventricular hypertrophy provides regression of the latter and improves left ventricular diastolic function, pumping capacity. In the course of arterial hypertension correction relevant patients with associated coronary heart disease improved their condition, demonstrated less frequent ECG changes indicative of ischemia.

[Ramipril in the treatment of hypertension. The pharmacodynamic validation of its efficacy in the therapy of initial cardiac and renal involvement]. / Ramipril pri lechenii gipertonicheskoi bolezni. Farmakodinamicheskoe obosnovanie éffektivnosti terapii nachal'nykh porazhenii serdtsa i pochek.

A clinical trial of 75 hypertensive subjects in stage II of the disease receiving ramipril monotherapy has established a marked efficacy of the above treatment. Individually adjusted single doses varied from 2.5 mg to 7.5 mg/day. The drug was well tolerated and had mild adverse effects (dry cough) in 2% of the patients. Long-term 12-week ramipril treatment in effective for hypertension doses is able to reduce myocardial mass without inhibition of the pumping capacity in the patients with left ventricular hypertrophy of the myocardium. In primary signs of nephroangiosclerosis hypertension correction was associated with improvement of filtration function and an increase in effective renal flow of plasma. The above pharmacodynamic effects make it possible to consider ramipril an effective hypotensive agent with organ-protective properties.

[The effect of isradipine on the central and cerebral hemodynamics of patients with circulatory encephalopathy and hypertension]. / Vliianie isradipina na tsentral'nuiu i tserebral'nuiu gemodinamiku u bol'nykh s distsirkuliatornoi éntsefalopatiei i gipertoniei.

The new dihydropyridine calcium antagonist isradipine versus nifedipine was tested in 41 patients with essential hypertension and cerebrovascular insufficiency. The tests have shown that isradipine shows all hemodynamic effects by significantly improving cerebral blood flow and it is better tolerated than nifedipine. It is concluded that isradipine is an effective agent in the long-term management of hypertensive patients at a high risk for cerebral hypoperfusion.