[Clinico-metabolic effects of fish oil in patients with ischemic heart disease, familial hyperlipoproteinemia and hypertension]. / Izuchenie kliniko-metabolicheskikh éffektov ikhtienovogo masla u bol'nykh ishemicheskoi bolezn'iu serdtsa, semeinoi giperlipoproteidemiei, gipertonicheskoi bolezn'iu.

Fifty-five patients with ischemic heart disease, familial hyperlipoproteinemia type IIb and essential hypertension kept anti-atherosclerosis diet incorporating 20 g of ichthyenic oil for 4 weeks. The diet resulted in positive shifts in clinical manifestations, a fall in blood levels of total cholesterol, triglycerides, atherogenic coefficient. The clotting time and duration of hemorrhage proved longer. As to fatty acid composition of red cell and platelet membranes, proportion of omega-6 reduced, while the share of omega-3 rose. This may underly inhibited synthesis of PGE2 and PGF2 alpha noted in the examinees.

[Characteristics of sodium metabolism in rats with experimental hypertension caused by chronic alimentary imbalance]. / Osobennosti obmena natriia u krys s éksperimental'noi gipertenziei, obuslovlennoi khronicheskim alimentarnym disbalansom.

Beginning from 1.5 month of life Wistar rats were kept under conditions of chronic 1 and 2% salt loading combined with a low-protein diet (6-8% of protein VS, as compared with 23-24% in the normal diet). At the age of 14-16 months when a stable hypertension developed due to the above alimentary imbalance, their sodium metabolism was studied using whole-body radiometry with 22Na. A three-chamber model of 22Na metabolism was developed for the analysis of 22Na excretion from the body. This helped in establishing the heterogeneity of sodium metabolism in experimental animals. Besides that, it has been shown that not only sodium retention in the body, but also its redistribution between intra- and extravascular sections play an important role in the development of hypertension. Protein deficiency in the diet aggravates sodium metabolism disorders in experimental animals.

[The psychological predictors of the participation of hypertension patients in low-sodium diet therapy]. / Psikhologicheskie prediktory uchastiia bol'nykh gipertonicheskoi bolezn'iu v giponatrievoi dietoterapii.

According to the Multifactorial rating scale, the Russian version of Mini-Mult, the Luscher color test and the "Quality of Life" test data the noncompliance patients were characterized by tension, anxiety, irritability, fatigue, low mood, interpersonal relations problems accompanied by the lowering of psychosocial adaptation and quality of life. On the basis of an objective psychological assessment the mathematic formulas for prediction of noncompliance as well as compliance towards hyposodium dietetic therapy have been elaborated.

[Sodium metabolism in Wistar rats exposed to chronic isotonic salt load after preliminary protein deficiency in the diet according to radiometry of the whole body with 22-Na]. / Obmen natriia u krys vistar v usloviiakh khronicheskoi izotonicheskoi solevoi nagruzki posle predvaritel'nogo defitsita belka v diete po dannym radiometrii vsego tela s 22Na.

The long-term preliminary protein deficiency in the diet gives rise to irreversible changes in sodium metabolism in experimental animals exposed subsequently to chronic salt load combined with full-value feeding. Apparently such changes do not go, however, beyond the compensatory potentialities of the body exposed to isotonic salt load, since the systolic arterial pressure does not undergo any material changes throughout the whole experiment.

[Characteristics of water-electrolyte balance in patients with labile essential hypertension and various approaches to the optimal therapy with diuretics and low-sodium diet]. / Osobennosti vodno-élektrolitnogo obmena u bo'lnykh gipertonicheskoi bolez'niu s labi'lnoi gipertenziei i nekotorye podkhody k optimi- zatsii terapii diuretikami i dietami s nizkim soderzhaniem natriia.

A study of 56 males, aged 22 to 56 years, with uncomplicated essential hypertension, stages IB-IIA, where pretreatment examination was followed by repeat investigation after 4 or 5 weeks of treatment with diuretics or low-sodium diets with strict (less than 2 g), moderate (up to 3 g), or mild (4-4.5 g) restriction of sodium uptake, demonstrated a tendency to sodium retention with fluid redistribution from the interstitium to intravascular space in the presence of diuretic treatment. Where dietary sodium was reduced, extracellular sodium was increased owing to increased residual sodium, while total metabolic sodium dropped, and extracellular fluid increased owing to the increase in interstitial fluid. All three variants of the low-sodium diet produced changes in sodium metabolism, with a drop in systemic residual sodium and arterial blood pressure. It is proposed to use strict limitation of dietary sodium for a limited period of time, to be followed by a transition to mildly limited sodium uptake after arterial BP is brought down and stabilized.

[Characteristics of sodium metabolism in Wistar rats in relation to the uptake of sodium chloride studied by whole body Na-22 radiometry]. / Osobennosti obmena natriia u krys linii Wistar v zavisimosti ot urovnia potrebleniia povarennoi soli po dannym radiometrii vsego tela s radionuklidom 22Na.

The rate of sodium elimination was shown to be inadequate to sodium uptake in rats exposed to prolonged salt loading, the higher the load, the greater the inadequacy. Sodium distribution between vascular and extravascular spaces of the body was also disproportionate in conditions of both excessive and low sodium uptake.

[Modeling of experimental hypertension by chronic salt loading combined with a low-protein diet in Wistar rats]. / Modelirovanie eksperimental'noi gipertonii s pomoshch'iu khronicheskoi solevoi nagruzki v sochetanii s nizkobelkovoi dietoi u krys Vistar.

Combination of chronic salt loading with protein-poor diet produces experimental hypertension with natrium consumption near to physiological. The present model is characterized, compared to the existing one, by stage development, moderate arterial blood pressure elevation and absence of "salt toxicosis" and may be thus considered more adequate for experimental investigation of primary arterial hypertension pathophysiology.

[Effect of physical load and brief monotherapy with obsidan on the characteristics of beta 2-adrenoreceptors of intact lymphocytes in patients with hypertension]. / Vliianie fizicheskoi nagruzki i korotkogo kursa monoterapii obzidanom na kharakteristiki beta 2-adrenoretseptorov intaktnykh limfotsitov bol'nykh gipertonicheskoi bolezn'iu.

Lymphocytes beta 2-receptor density (LBRD) was studied by binding with 125ICYP in 18 male patients with mild/moderate essential hypertension (EH) before and after propranolol monotherapy. In 5 of these patients LBRD was determined before and after dynamic exercise also. Propranolol therapy evoked different changes in LBRD in patients with EH. According to these results, all the patients were divided into 2 groups: the patients who respond to propranolol administration by an increase in the LBRD were attributed to the 1 group. If the LBRD decreased after propranolol, the patients were attributed to the 2 group. Propranolol had pronounced hypotensive effect in the 2 group and no hypotensive effect in the 1 group. Heart rate was significantly higher initially and decreased significantly more after treatment in the 2 group. In this group initial values of LBRD were significantly higher than in the 1 group. Exercise produced different changes in LBRD, which correlated with the changes produced by propranolol treatment. The positive correlations were found between LBRD and left ventricular myocardial mass and interventricular septum thickness. The data obtained indicate that LBRD is regulated in a qualitatively different manner in the two groups of patients with EH which appears to be related to baseline renin or perhaps catecholamine levels.

[Various immunological aspects of essential and symptomatic hypertension]. / Nekotorye aspekty immunologii gipertonicheskoi bolezni i simptomaticheskikh gipertonii.

131 patients with essential hypertension (EH) and 30 patients with secondary hypertension (SH) of renal genesis were examined, all of them Russian inhabitants of Moscow, aged 20-56. In patients with EH increased rate of HLA-B13 and B22 antigens was determined. The highest rate of HLA-B13 antigen in this group was registered in patients without IHD, while patients with IHD had the highest rate of HLA-B22 antigen compared to controls. Patients with SH demonstrated no significant difference in HLA antigens distribution from that in controls. Besides, patients with EH had significantly increased serum concentration of circulating immune complexes (CIC), of IgA and beta 2-microglobulins as well as of three complement components (C3c, C4 and B factor). Similar changes were observed in patients with SH, excluding CIC and C3c, concentration of which did not differ from that in the control group. No strict dependence between the level of immunity humoral factors and presence of HLA-B13 and -B22 antigens was observed. The data gained suggest possible association of HLA system with EH development.

[Body water compartments of patients with chronic heart failure and the refractory edema syndrome]. / Vodnye prostranstva u bol'nykh s khronicheskoi serdechnoi nedostatochnost'iu, refrakternym otechnym sindromom.

Using modern methods of investigation body water spaces were studied in 44 persons: 12 healthy ones and 32 patients with various degrees of heart failure. Significant changes in the content and distribution of water with regard to a degree of decompensation were revealed. Dilatation of the volume of extracellular fluid (VEF) was observed in patients with noticeable peripheral edemas as a result of an increase in the volume of circulating plasma (VCP) and an increase in the volume of interstitial fluid (VIF). A considerable increase in the total body water (TBW), VEF and vascular and interstitial portions were noted in the patients with stage IIB-IIIA heart failure in the presence of ascites. The division of the patients into 2 subgroups with relation to the results of subsequent dehydration therapy (22 patients were given diuretic therapy, in the other 10 patients it was supplemented with isolated ultrafiltration due to the refractory edematous syndrome) revealed distinct difference in the basal state of water spaces which manifested itself in a significant increase in VEF and VCP in patients with the refractory edematous syndrome. Thus a study of body water spaces in patients with chronic heart failure was important for the definition of groups of patients with resistance to diuretic therapy. A study of the time course of these parameters under the influence of various dehydration methods is of great interest. A special paper devoted to the problem, will be prepared by the authors.

[Effect of a beta 2-blocker on the adrenergic receptors of lymphocytes in hypertension]. / Deistvie beta 2-blokatora na adrenergicheskie retseptory limfotsitov pri gipertonicheskoi bolezni.

A short-term effect of propranolol on beta 2-adrenoceptor density in mononuclear lymphocytes was studied in 15 male patients with essential hypertension. According to receptor density alterations the hypertensive subjects were divided into two groups. In the first group lymphocyte beta 2-receptor density increased substantially (3 times, on the average). Propranolol had a weak antihypertensive effect in this group, with the initially low plasma renin activity remaining unchanged after the treatment. The patients of the second group, on the contrary, revealed features of sympathetic hyperactivity and a decrease (2 times on the average) in lymphocyte beta 2-receptor density. Propranolol administration caused a decline in the initially normal or elevated plasma renin activity as well as in systolic arterial blood pressure and heart rate.

[Characteristics of the water-electrolyte metabolism of hypertension patients with stable hypertension and the principles of diuretic therapy]. / Osobennosti vodno-élektrolitnogo obmena u bol'nykh gipertonicheskoi bolezn'iu so stabil'noi gipertenziei i nekotorye printsipy terapii diuretikami.

Different levels of water-salt metabolism control were studied in patients with stable essential hypertension (SEH). The sample was found to be highly heterogeneous in terms of the magnitude of the body's water-filled spaces in relation to plasma renin activity (PRA) and the cooking salt gustatory sensitivity threshold, examined in the presence of various salt diets and diuretic treatments. Three patterns of response to salt loads were identified in SEH patients with respect to sodium and water elimination by the kidneys: the first was identical to that of normal subjects, while the second one featured increased, and the third one, decreased, diuresis and natriuresis. Prostaglandin E2 and kallikrein were shown to be involved in the formation of the second- and third-type renal response to excessive salt. Differential treatment of EH patients with diuretics alone or, where necessary, in combinations with small-dose beta-blockers or vasodilators provides effective BP control for some 1.5 to 2 years in 65% of patients.

[Distribution of HLA antigens in patients with hypertension]. / Raspredelenie antigenov HLA u bol'nykh gipertonicheskoi bolezn"iu.

An immunogenetic study of 71 patients with essential hypertension associated with no signs of heart or renal failure, and 276 normal Russian male residents of Moscow demonstrated a significantly increased frequency of antigens HLA-B13 (p less than 0.01) and HLA-B22 (p less than 0.05), as well as HLA-A11 (p less than 0.05), in the hypertensive sample. Aggravated heredity (familial hypertension) was established in 64% of hypertensive carriers of antigens HLA-B13 and HLA-B22.

[Changes in body fluid spaces in hypertension patients treated with different diuretics]. / Izmeneniia vodnykh prostranstv organizma u bol'nykh gipertonicheskoi bolezn'iu pri lechenii razlichnymi diuretikami.

Body fluid spaces: total body fluid volume, extracellular fluid volume, circulating plasma volume, intracellular and interstitial fluid volumes were studied in 60 patients with essential hypertension, stage IIB. The studies were performed prior and following a two-week treatment with diuretics ( furosemid , oxodolin , hydrochlorothiazide, brinaldix ). The patients were divided into 3 groups. I--patients whose total body fluid volume was considerably increased due to intracellular fluid. They had the highest blood pressure level. Treatment with diuretics was the most effective in this group and was accompanied by intracellular fluid reduction and slight circulating plasma volume decrease. II--patients whose fluid spaces did not differ from those of normal subjects. Treatment with diuretics was effective and accompanied by simultaneous reduction in intracellular and interstitial fluid volumes. III--patients with reduced interstitial fluid volume and raised circulating plasma/interstitial fluid ratio. Treatment with diuretics was ineffective and accompanied by intracellular fluid level reduction and fluid passage from the vascular bed into the interstitial space. Furosemid and oxodolin were most effective decreasing intracellular fluid volume, hydrochlorothizide --reducing interstitial fluid volume and brinaldix was equally effective decreasing both fluid volumes.

[Pathophysiologic role of the level of taste sensitivity to table salt and its determination during treatment of hypertension with diuretics]. / Patofiziologicheskaia rol' urovnia vkusovoi chuvstvitel'nosti k povarennoi soli i opredelenie ego pri lechenii bol'nykh gipertonicheskoi bolezn'iu diuretikami.

Sixty hypertensive patients (stage IIB, no complications) were studied. Gustatory sensitivity threshold to salt was determined and body fluid volume, extracellular fluid volume, intracellular fluid volume, circulating plasma volume and interstitial fluid volume were measured in the control period and 2-3 weeks after treatment with diuretics. 27, 63 and 10% of patients had low, moderate and high gustatory sensitivity threshold, respectively. Patients with different gustatory sensitivity threshold to salt were identical in body fluid volume with peculiar extracellular fluid distribution between intravascular and interstitial spaces. In patients (72%) with a favourable hypotensive effect of diuretic therapy the reduction in gustatory threshold to salt was significant.

[Standardization in the study of water-containing spaces in patients with hypertension]. / Standartizatsiia v issledovanii vodnykh prostranstv organizma u bol'nykh gipertonicheskoi bolezn'iu.

The study of hypertensive and normotensive patients has shown that as body weight increases the size of water-containing spaces decreases due to an improportional increase of the body surface area. The rise of total water content occurs mostly due to intracellular fluid. Patients with different sodium chloride consumption are characterized by different redistribution of extracellular fluid. Patients with low basal plasma renin activity, unlike those with normal renin activity, are characterized by different fluid distribution in watercontaining spaces and no interrelation between plasma renin activity and extracellular volumes.

[Continuous long-term treatment with diuretics of hypertension and the status of the renin-angiotensin-aldosterone system]. / O dlitel'nom nepreryvnom lechenii diuretikami bol'nykh gipertonicheskoi bolezn'iu i sostoianie renin-angiotenzin-al'dosteronovoi sistemy.

One hundred fifty eight patients with essential hypertension (both in- and out-patients) at stages IIA and IIB were treated with diuretics: furosemide (120 mg/day) during three days followed by hydrochlorothiazide in the doses that allow maintaining the renal sodium and water transport of the changed level. Criteria developed for prognosis of the efficiency of diuretic therapy according to the degree of reduction of the mean BP and plasma renin activity after 3-day furosemide intake; indications were worked out for a simultaneous prescription of the potassium-sparing drug amiloride. A good hypotensive effect was noted (reduction of the mean BP by 10 mm Hg) during the first month of treatment in 60 and 70% of in-patients, and in 22 and 40% out-patients with IIB and IIA stages of the disease, respectively. During 6 months of prolonged treatment with diuretics (1-2 years) the sensitivity of the patients to the therapy was increased that permitted the dose of hydrochlorothiazide to be reduced to 25 mg a day or every other day. Patients with good hypotensive effect of therapy were noted to have less pronounced degree of activation of the renin-angiotensin-aldosterone system, than that in patients with ineffective treatment.