[Hypertensive crisis: problems of diagnostics and paradigm of the treatment].

Analysis of causes of increase of the uncomplicated hypertensive crisis (HC) from 46 to 61% indicates that in the half of cases the cause was only high ABP with minimal clinical symptomatology. To refer all cases of the catadrome of hypertensive disease to hypertensive crisis is inappropriately. It is recommended to use with such concepts as "complicated" and "uncomplicated" HC also term "catadrome of hypertensive disease (instability of ABP)". It allows to except the hyperdiagnosis of HC and to optimize indication for hospital admission. There are recommendations for medical actions in case of complicated and uncomplicated HC and catadrome of hypertensive disease.

[Hypertensive disease: diagnostics and differential methods of antihypertensive therapy].

Diagnostics of hypertensive disease is performed according two-stage scheme recommended by Society of cardiology of Russian Federation (2010) and adapted by us for examination in Central Military Clinical Hospital n. a. N.N. Burdenko. First stage, as possible, should be carried out in out-patient departments, second stage, as it necessary, in specialized medical treatment facilities. Indications for admission of patient with hypertensive disease are abstrusity of diagnosis and necessity of carrying out of special, often invasive study, for updating of information about the form of arterial hypertension, difficulties in adjustment of antihypertensive therapy. Major criterion for adjustment of antihypertensive therapy is degree of cardiovascular risk. In the beginning of treatment monotherapy is preferable for patients with low and average risk of progression of cardiovascular disease, use of combination of two or three medications in small doses is reasonable for patients with high and very high risk of complications. Three medications were prescribed for 21% of patients, four or five for 14% of patients.