[Refractory hypertension: diagnosis and treatment optimization].

Resistant hypertension occurs in up to 15% of patients with arterial hypertension in Russia. Medical treatment of resistant hypertension must include minimum 3 medications with maximum or maximum tolerated doses besides one of the medications must be diuretic. According to department of arterial hypertension of the Burdenko Main Military Clinical Hospital to achieve the target levels of arterial blood pressure it was necessary to prescribe 4-5 components antihypertension therapy in patients. Authors suggested an algorithm of diagnosis and treatment of patients with resistant hypertension with the help of surgical method. This method is based on decreasing of sympathic nervous system activity by selective break of neuronal connections with the help of interventional intravascular radio-wave ablation. Endovascular renal sympathetic denervation allows to effectively control arterial blood pressure, to optimize antihypertensive therapy, but this method does not cure from arterial hypertension.

[The first experience with the use of catheter denervation of renal arteries in patients with refractory hypertension].

The prevalence of refractory arterial hypertension in Russia is estimated at 15%. We report the first experience with surgical treatment of this pathology. The method is based on the reduction of activity of the sympathetic nervous system by selective breaking of connections between of neurons with the help of interventional intravascular radiowave ablation. Renal endovascular sympathetic denervation allows to more effectively control AP and optimize antihypertensive therapy but does not ensure recovery from AH.

[The effects of mexicor on thrombocyte aggregation, blood viscosity, hemodynamics, and the clinical course of coronary artery disease].

The authors analyze their experience in the application of mexicor, a Russian cytoprotector, in 50patients with chronic coronary artery disease (CAD) and 51 patients with acute coronary syndrome. In additional to cytoprotective action, the use of mexidor in complex therapy of CAD lowers the functional activity of thrombocytes, eliminates high blood viscosity syndrome, and lowers low density lipoprotein cholesterol level. These favorable changes in hemorheological parameters improves myocardial perfusion, lowers the strength and frequency of coronary pain attacks, retards postinfarction left ventricular remodeling, and increases the quality of life of patients with various CAD forms.

[Fibrinolytic therapy of patients with pulmonary artery thromboembolism by tissue plasminogen activator and streptokinase preparations]. / Fibrinoliticheskaia terapiia bol'nykh s tromboémboliei legochnoi arterii tkanevym aktivatorom plazminogena i preparatami streptokinasy.

Changes in clinical and hemodynamic indices, hemostatic system during therapy with plasminogen tissue activator and streptokinase drugs were studied in 49 patients with massive and submassive forms of pulmonary thromboembolism. Conduction of fibrinolytic therapy with plasminogen tissue activator vs streptokinase produced more marked and rapid change in the main hemodynamic parameters which characterized blood recovery in pulmonary artery. A correlation was revealed between the change in hemostatic system after thrombolytic therapy and development of hemorrhagic complications. Preferable introduction of plasminogen tissue activator is shown when thromboemboli locate in the trunk or in both main pulmonary arteries and in the presence of an occlusive lesion in lobular arteries.