[Tactics of antihypertensive therapy during COVID-19 pandemic].

Results of foreign and Russian studies indicate a higher mortality rate of patients with concomitant cardiovascular diseases (CVD) due to the new coronavirus infection COVID-19. It has been proven that arterial hypertension, as one of the significant risk factors for the development of concomitant cardiovascular diseases, is associated with a more severe prognosis of COVID-19. This article presents the results of modern studies and large meta-analyzes of necessity and safety of the use of blockers of the renin-angiotensin-aldosterone system in patients with arterial hypertension and COVID-19. The data of studies show that an angiotensin-converting enzyme inhibitor (ACE inhibitor) and a thiazide-like diuretic is a pathogenetically rational combination. It realizes various ways of lowering blood pressure by reducing the activity of the renin-angiotensin-aldosterone system, which is achieved by using an ACE inhibitor, and natriuresis due to diuretics. As an example, a highly effective fixed combination of drugs is considered, characterized by good tolerance, which consists of an ACE inhibitor lisinopril and a thiazide-like diuretic indapamide of prolonged action. The authors expressed the opinion that the appointment of the fixed combination drug Diroton Plus (Gedeon Richter) will contribute to effective control of blood pressure and organoprotection in conditions of increased thrombogenic and prooxidative potential, characteristic of COVID-19 both in the acute stage and within the post-COVID Syndrome.

[Clinical, cardio- and hemodynamic effects of long- and short-acting beta-adrenergic blockers in the treatment of patients with stable stenocardia]. / Klinicheskie, kardio- i gemodinamicheskie éffekty neselektivnykh beta-adrenergicheskikh blokatorov prolongirovannogo i korotkogo deistviia pri lechenii bol'nykh stabil'noi stenokardiei.

Sixty-nine coronary heart disease patients with stable angina of effort of Classes II-IV of functional activity were studied for the effect of three nonselective beta-adrenergic blockers on the incidence and intensity of angina attacks, on the tolerance to exercise on the bicycle ergometer, as well as on the heart rate, arterial pressure, cardiac volumes and intracardiac hemodynamics using a complex of clinical and instrumental methods. It was proved that nadolol, pindolol and propranolol hydrochloride possessed similar anti-anginal effects but nadolol exerted the greatest negative chronotropic action while propranolol hydrochloride exerted a negative inotropic action. As regards the degree of the effect on cardiac volumes, corgard (nadolol) occupied an intermediate position between anaprilin (propranolol hydrochloride) and visken (pindolol).

[Modern aspects of nitro preparation use]. / Sovremennye aspekty primen eniia nitropreparatov.

On the basis of clinical examination and the results of bicycle ergometry and echocardiography in 58 patients with chronic ischemic heart disease the authors determined the contingent of patients in whom long-acting nitrates were most effective. The high clinical effectiveness of the agents in patients with symptoms of the initial stage of cardiac insufficiency is proved and the absence of any essential differences between long-acting nitrates in the character of their effect on hemodynamics is shown. It is established that nitroglycerin and long-acting nitrates cause a qualitatively similar effect on myocardial contractile function and intracardiac hemodynamics in patients with ischemic heart disease.

[Dynamics of the echocardiographic indices of myocardial contractile function in chronic ischemic heart disease under treatment with blockaders of the cardiac beta-adrenergic receptors]. / Dinamika ékhokardiograficheskikh pokazatelei sokratitel'noi funktsii miokarda u bol'nykh khronicheskoi ishemicheskoi bolezn'iu serdtsa pri lechenii blokatorami beta-adrenergicheskikh retseptorov serdtsa.

The article discusses the results of dynamic echocardiographic examination of 46 patients with chronic ischemic heart disease before and after 15-day treatment with agents capable of blocking beta-receptors: propranolol (anaprilin), pindolol (visken), talinolol (cordan) which were prescribed in mean therapeutical doses. It is shown that agents blocking beta-adrenergic receptors lead to regular decrease in the indices of myocardial contractility. The character of changes in the volumetric characteristics of the left ventricle depends on the initial levels of arterial pressure and the degree of its dynamics during treatment with beta-adrenergic blocking agents. In patients with chronic ischemic heart disease developing against the background of hypertensive disease the dynamics of changes in the volumetric indices depends on the degree of arterial pressure reduction.