[Primary prophylaxis of cerebrovascular complications in patients with metabolic syndrome].

AIM: To study effects of antihypertensive therapy with bisoprolol and actovegin on cerebral perfusion in patients with metabolic syndrome. MATERIAL AND METHODS: Thirty patients (18 women and 12 men) with metabolic syndrome and mild arterial hypertension took bisoprolol alone in a dose 5-10 mg/day, and fifteen patients received combined therapy (bisoprolol and actovegin) for 12 weeks. Before the study and 12 weeks later measurements were made of carbohydrate and lipid metabolism, single photon emission computed tomography investigated brain perfusion. RESULTS: Improvement of brain perfusion was observed after both monotherapy with bisoprolol and its combination with actovegin. CONCLUSION: Monotherapy with bisoprolol and bisoprolol combination with actovegin improved brain perfusion but the combination was more effective.

[Cerebral perfusion in patients with metabolic syndrome].

Cerebral perfusion was studied in patients with arterial hypertension combined with metabolic syndrome and diabetes mellitus type II. The data is compared to the results obtained for patients with a single disorder--metabolic syndrome, diabetes mellitus type II and arterial hypertension without metabolic alterations. It is shown that patients with disregulation of carbohydrate and lipid metabolism are more vulnerable to cerebral blood supply alterations. A level of perfusion was the same in patients with metabolic syndrome and diabetes mellitus type II. Besides, an acetazolamide application revealed that patients with metabolic syndrome had reduced cerebral vascular autoregulation.

[Body mass loss due to orlistat therapy and multiple factors of cardiovascular risk].

AIM: To study effects of body mass loss due to orlistat on carbohydrate and lipid metabolism, insulin resistance, 24-h profile of arterial pressure (AP), left ventricular myocardial hypertrophy, brain perfusion in patients with metabolic syndrome (MS). MATERIAL AND METHODS: Thirty middle-aged patients with MS entered the trial. They received orlistat in a dose 120 mg twice a day for 24 weeks. Before and after the treatment the patients' carbohydrate and lipid metabolism, insulin resistance were studied, 24-h monitoring of arterial pressure, echo-cardiography were made. Brain perfusion was studied with single-photon emission computed tomography in 18 patients. Results. All the patients lost much weight. This was accompanied with improved indices of AP profile, metabolism of carbohydrates and lipids, insulin resistance, left ventricular hypertrophy, brain perfusion. Conclusion. Orlistat treatment weakens basic factors of cardiovascular risk.

[Cerebrovascular complications in metabolic syndrome: possible approaches to decrease risk]. / Tserebrovaskuliarnye oslozhneniia pri metabolicheskom sindrome: vozmozhnye podkhody k snizheniiu riska.

AIM: To compare brain perfusion in hypertensive patients with diabetes mellitus type 2 (DM2) or metabolic (MS) syndrome and hypertensive patients without clinicobiochemical signs of DM2 or MS; to study enoxaparin effects on brain perfusion in DM2 and arterial hypertension (AH). MATERIAL AND METHODS: Seventy patients included in the study were divided into three groups: 30 patients with DM2 and AH (group 1), 30 patients with MS and AH (group 2) and 10 AH patients without manifestations of MS or DM2 (group 3). All the patients have undergone single-photon emission computed tomography (SPECT) of the brain, carbohydrate and lipid metabolism were examined. RESULTS: Deterioration of brain perfusion was more prominent in DM2 and MS patients with AH than in hypertensive patients with normal metabolism. Stress test with acetasolamide revealed defective autoregulation of cerebral blood flow in hypertensive patients with DM2. A 6-week therapy with enoxaparin significantly improved brain perfusion in hypertensive patients with DM2. CONCLUSION: Enoxaparin treatment of hypertensive DM2 and MS patients with abnormal perfusion of the brain can be used for prevention of cerebrovascular complications.

[Cardiovascular complications of type 2 diabetes]. / Serdechno-sosudistye oslozhneniia sakharnogo diabeta 2-go tipa.

Cardiovascular complications due to micro- and microangiopathy are main causes of death of patients with type 2 diabetes. Principal role in development of these complications belong to hyperglycemia which triggers such pathological processes as endothelial dysfunction, oxidative stress, impairment of hemostasis and blood rheology. Therefore glucose lowering therapy is pathogenetic not only for diabetes but also for its cardiovascular complications. Glucose lowering drugs should be maximally effective and safe for the cardiovascular system. These requirements gliclaside which in addition to pronounced glucose lowering effect also acts on all links of the pathogenesis of micro- and macroangiopathies. While selecting cardiovascular drugs one should take into consideration their effect on carbohydrate metabolism and cardioprotective properties. Angiotensin converting enzyme inhibitors are leaders in this field.