[CHANGES OF CAROTID AND VERTEBRAL ARTERIES IN PATENTS WITH ARTERIAL HYPERTENSION AND HEPATOBILIARY PATHOLOGY].

The study included 1172 patients (410 men and 762 women) at the mean age of 60.3 ± 10.4 years with grade I-II (stage I-II) arterial hypertension (AH) admitted to the clinic of Institute of Experimental Medicine. The patients were divided into 2 groups based on the results of clinical and laboratory diagnostics. Group 1 (n = 525) included patients with AH and hepatobiliary system (HBS) diseases, group 2 (n = 647) patients with AH without HBS diseases. The patients group 1 had a thicker intima-media complex of carotid arteries, higher peak systolic bloodflow rate in the internal and vertebral carotid arteries, more pronounced coiling of internal carotid arteries than patients of group 2. Patients with AH and HBS diseases exhibited correlation between bloodflow rate in external carotid arteries and atherogenicity coefficient. Duplex scanning of neck vessels of in patients with AH without HBS diseases revealed peculiar changes of the intima-media thickness and hemodynamically significant changes of the blood flow in the internal carotid arteries that may be of prognostic value in this nosological syntropy and require the personified approach to diagnostics, treatment, and prevention of these conditions.

[Features of polymorbidity in cardiac and gastroenterologic patients from a therapeutic clinic].

AIM: To examine the incidence of polymorbidity (PM) and changes in its rates in 2003 to 2011 in cardiac and gastroenterologic patients living in the Novosibirsk Region and the Republic of Sakha (Yakutia) in accordance with gender, occupation, and residence. SUBJECTS AND METHODS: The dynamics of PM rates was analyzed in 13 496 patients who had been examined and treated at the Cardiology and Gastroenterology Departments, Therapeutic Clinic, Research Institute of Experimental and Clinical Medicine (Novosibirsk), 2003-2011. The study used an archival research method and a statistical analysis of all nosological entities, groups, and classes in ICD-10, regardless of whether the diagnosis was primary or concurrent. RESULTS: There was an increase in PM rates among the therapeutic clinic's patients of regardless of their gender and occupation. There were gender differences in the incidence of PM: its higher rates were noted in the women than those in the men among both the residents of the Novosibirsk Region and those of the Republic of Sakha (Yakutia). More significantly higher PM rates were registered in the male inhabitants of the Novosibirsk Region. There were also regional differences in the incidence of PM: its rates proved to be higher in the patients in the Republic of Sakha (Yakutia) than in those in the Novosibirsk Region in 2003-2007. At the same time, the growth rates for PM were more marked in the patients in the Novosibirsk region than in those in the Republic of Sakha (Yakutia); these differences levelled off in subsequent years. CONCLUSION: The findings indicate a pronounced increase in the incidence of PM in cardiac and gastroentorologic patients and determine a need to keep in mind the influence of gender, social, and regional factors on its development in order to create and improve a primary and secondary prevention, diagnosis and treatment system.

Chronobiological and morphofunctional aspects of arterial hypertension under circumpolar conditions.

INTRODUCTION: Nowadays the problem of population health in the northern areas is of great importance. While evaluating human adaptation to the extreme geoecological northern conditions the state of the cardiovascular system can be used as an index of effective compensatory adaptation. STUDY DESIGN: The data on 24-hour BP monitoring, data of echocardiography and heliogeophysical factors in different periods of ontogenesis in 317 patients, living in the north of the Tyumen region, were analysed to estimate the morphofunctional and chronobiological peculiarities of arterial hypertension. RESULTS: Considerable disorders of haemodynamic circadian rhythms, manifesting either insufficient decrease of BP at night are revealed in the examined subjects. Above 42.2% of such patients have myocardial hypertrophy. Insufficient night decrease of BP is typical for the examined patients, with coupling of the indices of haemodynamic and current geomagnetic activity. The peculiarities of heliogeophysical factors at early ontogenesis of the examined subjects with an increased variability and decreased circadian index of BP are defined using multivariate analysis. CONCLUSION: Thus, a combination of disorders of temporary haemodynamic organisation with the morphological changes of myocardium and peculiarities of biogeophysical coupling of the examined is shown. This anthropoecological approach can be used for the diagnostics and treatment of arterial hypertension under conditions of the northern ecosystem.