[Effect of Antihypertensive Drugs on Regression of Left Ventricular Hypertrophy].

In this review we show that combination treatment with blockers of renin-angiotensin-aldosterone system and dihydropyridine calcium antagonists plays the leading role in lowering of left ventricular myocardial mass. We also demonstrate benefits of the use of fixed combinations of drugs for the treatment of patients with arterial hypertension including those with left ventricular hypertrophy, and stress advantages of angiotensin II receptor blockers characterized by low risk of unfavorable effects and high compliance to treatment over other classes of antihypertensive drugs.

[Clinical Value of Left Ventricular Hypertrophy in Arterial Hypertension].

In this review article we present data on prevalence of left ventricular hypertrophy in patients with arterial hypertension, on predictors of its development, methods of detection, and diagnostic criteria.

[Analysis of the effect of antihypertensive drugs on left ventricular hypertrophy regression].

In a review article reflects the leading role of combined treatment of blockers of the renin-angiotensin-aldosterone system and dihydropyridine calcium antagonists in reducing left ventricular mass. The advantages of fixed combinations in the treatment of hypertensive patients, including those with left ventricular hypertrophy. The advantages of the low risk of side effects and high patient adherence to treatment using antagonists of angiotensin II receptor in comparison with other classes of antihypertensive drugs in selecting initial therapy, patients with hypertension, including the combination of drugs.

[The strategy, tactical approaches and choice of combination therapy in the treatment of patients with arterial hypertension].

This review article presents approaches to the selection of strategy of antihypertensive therapy in hypertensive patients according to the degree of elevation of blood pressure (BP), the level of risk for cardiovascular complications, the doses of drugs used in accordance with current guidelines. A comparative analysis of different strategic approaches is given. The importance of combined antihypertensive therapy, including fixed combinations, not only in terms of reducing BP, improving patient adherence to treatment, but also in terms of a favorable effect on the prognosis is shown. Rational combinations of antihypertensive drugs depending on the specific clinical situation are marked. Attention is paid to the new fixed combinations, including angiotensin converting enzyme inhibitors and calcium antagonists.

[Risk factors of development of left ventricular hypertrophy in patients with hypertensive disease with high compliance to treatment].

Aim of the study was to assess rate of development of left ventricular hypertrophy (LVH) and its risk factors in patients with hypertensive disease (HD) without target organs damage with high compliance to treatment. We included in this prospective cohort study 428 patients with HD without target organs damage. Duration of follow-up was 8.8+/-2.6 years. Rate of LVH development was 36.9%. It was more frequent in men (41.3%) than in women (32.7%). Intensity of antihypertensive therapy was higher in a group of patients with with left ventricular remodeling. Risk of development of LVH was associated with age especially in men older than 55 years, duration of hypertension, body mass, initial level of diastolic blood pressure, pulse blood pressure, level of low density lipoprotein cholesterol, and fasting level of glucose in blood plasma. Thus in patients with HD rate of LVH development at the background of high compliance to treatment is lower than in total population and has definite specific patterns.

[Preventing of stroke by antihypertensive drugs: potential and limitations]. / Profilaktika mozgovogo insul'ta s pomoshch'iu antigipertenzivnykh preparatov: vozmozhnosti i ogranicheniia.

Analysis of controlled randomized studies of efficacy of antihypertensive drugs in primary and secondary prevention of stroke is presented. Basing on this analysis a conclusion is made that in patients with hypertension representatives of all 4 main classes of antihypertensive drugs prevent stroke with similar efficacy. Magnitude of reduction of risk of both first and recurrent stroke is determined not by the class of a drug but by degree of blood pressure lowering. Special emphasis is made on necessity of careful approach to blood pressure lowering in elderly patients.

[Dynamics of physical exercise tolerance in patients with ischemic heart disease during the 1st year after direct myocardial revascularization operation]. / Dinamika tolerantnosti k fizicheskoi nagruzke u bol'nykh ishemicheskoi bolezn'iu serdtsa v techenie 1-go goda posle operatsii priamoi revaskuliarizatsii miokarda.

The bicycle ergometric testing was performed in different periods within the first year of direct myocardial revascularization by using microsurgical techniques. The parameters of physical fitness and myocardial blood flow were found to be substantially increased in the early periods of postoperation (10-18 days later), less increased at months 2-4, and then unchanged within the year. Thus, it is suggested that cardiovascular performance becomes stable 2-4 months after a successful operation. In this connection, the time the patients with coronary heart disease can resume work after the operation should be revised.

[Early prognosis of work capacity in patients with ischemic heart disease after direct myocardial revascularization]. / Rannii prognoz trudosposobnosti u bol'nykh ishemicheskoi bolezn'iu serdtsa posle operatsii priamoi revaskuliarizatsii miokarda.

The study was designed to estimate the clinical status and exercise tolerance in 25 patients in the preoperative and early postoperative periods, as well as at weeks 6-8 of direct myocardial revascularization performed by applying microsurgical techniques. The clinical status improved in all the patients. Their exercise tolerance was increased by 67 and 106% 2-3 and 6-8 weeks after the surgery, respectively. Thus, with uncomplicated coronary artery reconstruction, the patients can perform graded physical exercise in the early postoperative period, which provides evidence for reduction of a patient's stay in hospital.