[Efficacy and safety of different beta-blockers in patients with isolated systolic hypertension associated with diabetes mellitus and obstructive pulmonary diseases]. / Effektivnost' i bezopasnost' razlichnykh beta-blokatorov u patsientov s izolirovannoi sistolicheskoi gipertoniei i soputstvuiushchimi sakharnym diabetom i obstruktivnymi bolezniami legkikh.

AIM: To compare efficacy and safety of atenolol, methoprolol and bisoprolol, as the most usable beta-blockers, in patients with isolated systolic arterial hypertension (ISAH) and concomitant diabetes mellitus (DM) and/or chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: Forty tow patients with ISAH and coronary heart disease, 30 patients with these diseases associated with DM and 32 patients with associated COPD were randomized into three groups. Group 1 received atenolol in a dose 25 mg twice a day, group 2--metoprolol tartrate in a dose 25-50 mg twice a day, group 3--bisoprolol in a single dose 5-10 mg/day. All the patients were examined before the treatment and in 8 weeks. Arterial pressure was assessed at 24-h monitoring (ABPM-04 unit, Mediteck, Hungary) and quality of life (QL) was estimated by DISS Disability Scale. In addition, blood glucose was measured in patients with concomitant DM, external respiration function (ERF) was studied before and after the treatment in patients with concomitant COPD. RESULTS: In all ISAH patients there was a significant fall of systolic arterial pressure and heart rate. 2 hours after intake of atenolol and methoprolol blood glucose lowered significantly in diabetics as well as peak volume expiration velocity in patients with COPD. In the bisoprolol group ERF and blood glucose in DM and COPD patients remained unchanged. Atenolol deteriorated QL by the "job" and "social life" scales, methoprolol--by the scale "job" while bisoprolol improved the above parameters. CONCLUSION: The results of bisoprolol treatment are better than those of methoprolol and atenolol treatment of hypertensive patients with concomitant DM and COPD.

[Use of phisiotens for the treatment of arterial hypertension in elderly patients]. / Opyt pimeneniia fiziotenza dlia lecheniia arterial'noi gipertonii u pozhilykh.

AIM: To study effectiveness and safety of physiotens in elderly patients with essential hypertension (degree 1-2). MATERIAL AND METHODS: The trial enrolled 10 patients (6 males and 4 females) at the age of 60 to 75 years (mean age 66.4 +/- 3.7 years) with untreated or ineffectively treated essential hypertension (degree I-II by WHO classification). The disease stood for 17 +/- 5.3 years. Physiotens was given for 2 weeks in a single daily dose 0.2-0.4 mg. 24-h blood pressure monitoring, standard neuropsychological examination, echoCG, assessment of quality of life (Visual Analog Scale, Disability Scale) were performed before and after the treatment. RESULTS: Physiotens significantly reduced systolic and insignificantly diastolic pressure in daytime and at night; improved memory and thinking; 24 weeks of the treatment led to a decrease in left ventricular myocardium mass (by 13%, on the average) and in the thickness of left ventricular walls (by 7% on the average) as well as in life quality. CONCLUSION: Long-term physiotens treatment of elderly patients with mild and moderate hypertension provides a fall in day and night arterial pressure, regression of left ventricular myocardium mass, improves quality of life, memory and thinking.

[Changes in aortic elasticity in aged patients with essential arterial hypertension]. / Osobennosti izmeneniia rastiazhimosti aorty u pozhilykh bol'nykh s éssentsial'noi arterial'noi gipertenziei.

Aortic elasticity was studied in aged patients with mild and moderate arterial hypertension using magnetic resonance imaging. The analysis of changes in cross section area (CSA) of the ascending aorta in systole has shown that in some patients maximal CSA occurs in different systolic phases while in the other patients CSA remains unchanged. Calculation with the elasticity rate proved that patients with maximal aortic diameter at the beginning of the systole have maximal aortic elasticity while those with minimal changes in aortic diameter in the course of the systole have minimal elasticity. Thus, in aged patients with mild and moderate essential hypertension aortic wall loses its elasticity to different extent. Further studies will specify clinical and pathogenetic implications of reduced aortic elasticity in arterial hypertension.

[Correction of sleep disorders and efficacy of antihypertensive monotherapy in elderly patients: use of ivadal]. / Vzaimosviaz' korrektsii narushenii sna i éffektivnosti antigipertenzivnoi monoterapii u pozhilykh bol'nykh: vozmozhnosti primeneniia ivadala.

AIM: To assess effects of ivadal (zolpidem) on arterial pressure (AP) in the cycle sleep-awake in aged patients with insomnia who have failed hypotensive monotherapy with different drugs, i.e. whose AP remained abnormal at night. MATERIALS AND METHODS: The trial included 25 aged patients (17 females, 8 males, mean age 66.4 +/- 3.7 years) with isolated systolic arterial hypertension (AH) of the first-second degree (WHO classification, 1999) and insomnia. AH duration averaged 8.7 +/- 3.7 years. All the patients have received antihypertensive monotherapy. As shown by the initial 24-h monitoring, patients with elevated night AP had significantly lower mean score by the questionnaire "Subjective Sleep Characteristics" and more frequently suffer from insomnia. These patients were given a hypnotic drug ivadal (zolpidem) in a single daily dose 5 mg in the evening for 10 days. On the treatment night 10 monitoring of AP was repeated. RESULTS: Ivadal treatment has significantly improved all the subjective parameters of sleep and 24-h AP profile, lowered sleep and awake AP. CONCLUSION: Ivadal treatment raises efficacy of a hypotensive monotherapy in aged patients with isolated systolic AH and insomnia.