[Masked Arterial Hypertension in Employed Adult Women: Aspects of Screening and Prognostication].

Masked (M) hypertension (H) remains an unsolved problem of cardiology. Gender aspects of MH require further pathogenetic deciphering and clinical interpretation. We used breathe-hold test and 24-hour blood pressure (BP) monitoring for detection of MH in 275 female middle- aged employees. MH Prevalence of MH was 7.7%. Special clinical and pathogenetic characteristics of MH in studied sample were as follows: high sensitivity of mean hemodynamic BP; body mass index increase, tendency to elevation of fasting glycaemia and lowering of glomerular filtration rate, more frequent presence of dyslipidemia in comparison with normotensive patients, absence of association with levels of anxiety and depression. Ten year risk of fatal cardiovascular events in women with MH was comparable with that among female patients with overt hypertension (0.76 vs 0.68 %). Received data became a basis for elaboration of screening programs of early detection and prevention of H.

[Cardioprotective capabilities of drug meldonium in secondary prevention after percutaneous coronary intervention in patients with documented myocardial ischemia].

The purpose of research ­ analysis of capabilities in cytoprotective drug mеldonium, in complex in the cardioprotective effect of secondary prevention after percutaneous coronary intervention (PCI). Patients with stable coronary heart disease (n=35 ) aged ≤65 years with incomplete revascularization at 6 months after PCI and positive exercise test (SFI) were randomized 1:1 to groups controlled physical training (CPT) with intensity 80% and a duration of 2 weeks (10 SFI): group 1 (n=17; 53,9±6,2 years) and group 2 (n=18; 56,1±4,8 years). Patients in Group 1, in addition to SFI mеldonium administered at a dose of 1000 mg/ml intravenously. In the 1st group on the background mеldonium adjunctive therapy showed a significant increase in the duration from 15±2 to 32±7 min for the 10th CPT (p<0.05). Index of maximum oxygen consumption after 10 intense CPT increased to 20.8±1.06 ml/kg/min compared to baseline (18.6±1.1 ml/kg/min, p<0.05) and the control group (18.5±1.5 ml/kg/min, p<0.05). Use of meldonium was also associated with decrease of maximum ST-segment depression (from -0.18±0.1 to 0.10±0.2 mV), increases of exercise duration (from 364±22 to 556±29 s) threshold heart rate (from 118±12 to 132±5 bpm), decrease of time of ST segment recovery to baseline (from 385±32 to 242±22 s, p<0.05). Final level of free fatty acids in the meldonium group was significantly lower than that in the control group (0.248±0.047 vs. 0.265±0.031 mg/dl). Inclusion of meldonium in complex treatment after PCI potentiates cardioprotective effect of intensive CPT as evidenced by the positive dynamics of ECG and biochemical markers of myocardial ischemia.

[Functional screening test for latent arterial hypertension detection in young patients].

We assessed diagnostic value of acute-hypoxia test (AHT) for detection of latent arterial hypertension in 317 young persons from different social groups (mean age 25.6+/-5.1 yrs) without clinical signs of cardiovascular diseases. We performed AHT and ambulatory blood pressure monitoring (ABPM). Sensitivity and specificity of AHT for detection `of latent arterial hypertension were 97.9 and 94.7%, respectively. Agreement of results of AHT and ABPM was 79.6% in patients with high normal blood pressure (BP) and 100% in patients with BP >140/90mm Hg. The test was safe and its results were highly reproducible.

[Correction of NO-dependent cardiovascular disorders by adaptation to hypoxia]. / Korrektsiia NO-zavisimykh serdechno-sosudistykh narushenii s pomoshch'iu adaptatsii k gipoksii.

Spontaneously hypertensive rats (SHR-SP) were adapted to intermittent hypobaric hypoxia in an altitude chamber for 40 days. The adaptation to hypoxia prevented an excessive endothelium-dependent relaxation and hypotension characteristic of myocardial infarction. The adaptation also attenuated the increase in blood pressure and prevented impairment of the endothelium-dependent relaxation in SHR-SP. The universal nature of the adaptation allows to use it for correcting many cardiovascular disorders related to diverse alterations of NO metabolism.

Role of nitric oxide in adaptation to hypoxia and adaptive defense.

Adaptation to hypoxia is beneficial in cardiovascular pathology related to NO shortage or overproduction. However, the question about the influence of adaptation to hypoxia on NO metabolism has remained open. The present work was aimed at the relationship between processes of NO production and storage during adaptation to hypoxia and the possible protective significance of these processes. Rats were adapted to intermittent hypobaric hypoxia in an altitude chamber. NO production was determined by plasma nitrite/nitrate level. Vascular NO stores were evaluated by relaxation of the isolated aorta to diethyldithiocarbamate. Experimental myocardial infarction was used as a model of NO overproduction; stroke-prone spontaneously hypertensive rats (SHR-SP) were used as a model of NO shortage. During adaptation to hypoxia, the plasma nitrite/nitrate level progressively increased and was correlated with the increase in NO stores. Adaptation to hypoxia prevented the excessive endothelium-dependent relaxation and hypotension characteristic for myocardial infarction. At the same time, the adaptation attenuated the increase in blood pressure and prevented the impairment of endothelium-dependent relaxation in SHR-SP. The data suggest that NO stores induced by adaptation to hypoxia can either bind excessive NO to protect the organism against NO overproduction or provide a NO reserve to be used in NO deficiency.