[Effects of ACE inhibitor fosinopril on a 24-h profile of arterial pressure in hypertensive patients with obesity and hypercholesterolemia].

AIM: To study effects of fosinopril on a 24-h profile of blood pressure (BP) in hypertensive patients with obesity and hypercholesterolemia. MATERIAL AND METHODS: A randomized comparative trial enrolled 96 patients aged 30-50 years with arterial hypertension (AH) of the first and second degree. The patients were randomized into 2 groups by age, gender, AH duration, office AP, body mass index, cholesterol level. The patients of group 1 received fosinopril (monopril) in a single daily dose 10 mg with further rise to 20 mg. The patients of group 2 were given metoprolol twice a day in a dose 25 mg with further rise to 75 mg. Examination of the patients was made before the treatment and after 16 weeks of therapy with fosinopril and metoprolol. RESULTS: A 16-week therapy with fosinopril resulted in lowering of office BP, mean day systolic, diastolic, pulse BP. The profile of SBP improved: the number of "dippers" with an adequate day profile of BP rose. Fosinopril significantly reduced left ventricular myocardial mass (LVMM) and myocardial mass index. Metoprolol had the same hypotensive action but had no effect on mean 24-h pulse and mean BP, LVMM, LVMM index. CONCLUSION: Fosinopril is more effective than metoprolol in relation to a 24-h profile of BP and LVMM reduction.

[Effects of angiotensin-converting enzyme (ACE) inhibitors on water-salt homeostasis in hypertensive patients living in Far North]. / Vliianie ingibitorov angitenzinprevrashchaiushchego fermenta na sostoianie vodno-solevogo gomeostaza u bol'nykh arterial'noi gipertoniei v usloviiakh Krainego Severa.

The aim of the study was evaluation of ACE inhibitors (captopril and ramipril) effect on water-salt homeostasis in the treatment of patients with arterial hypertension (AH) living in the Far North of Russia. 100 male patients with mild and moderate AH were examined 2 weeks, 3 and 6 months after administration of captopril or ramipril. The drugs are shown to correct water-salt metabolism. This is explained by better renal function due to speeding up glomerular filtration and increased sodium excretion with urine, and by activity of humoral mechanisms (inhibited activity of plasma renin, low plasma concentration of aldosterone and its 24-h excretion). Comparison of captopril versus ramipril demonstrates advantages of prolonged ramipril in respect to regulation of water salt metabolism in the treatment of essential hypertension in the Far North.

[Efficacy of emoxipin in treatment of arterial hypertension in the Far North]. / Effektivnost' émoksipina v lechenii arterial'noi gipertonii na Krainem Severe.

A total of 95 hypertensive men working in duty regimen in the extreme North were examined. The men were found to have lipid metabolism disorders, activation of lipid peroxidation, decreased antioxidant defense in red cell membranes in all the examinees vs control hypertensive men living in moderate climatic zone. Effect of 2-week monotherapy with emoxipin was studied in 29 males with mild arterial hypertension free of obesity and coexisting diseases. Placebo was given to 10 patients. Emoxipin had an antihypertensive and antioxidant effects, improved structural-functional condition of erythrocytes in hypertensive patients.

[Role of cell membrane abnormalities in the etiology of arterial hypertension]. / Rol' patologii kletochnykh membran v formirovanii arterial'noi gipertonii.

AIM: To study the role of cell membrane disorders in the formation of arterial hypertension under conditions of Extreme North. MATERIALS AND METHODS: A total of 128 men aged 20-48 years with essential hypertension (EH) were examined. All of them worked in the duty regimen at the Extreme North. Control group consisted of EH patients living in the temperate climatic zone. Central and peripheral hemodynamic parameters and cell membrane characteristics were studied: activities of transmembrane ion transport enzymes, intracellular electrolytes sodium and calcium, lipid peroxides (LPO), antioxidant defense values in erythrocyte membranes, plasma and cell membrane cholesterol. RESULTS: Activation of LPO processes and decreased antioxidant defense in both groups modified the lipid spectrum of cell membranes. The levels of intracellular calcium and sodium were increased, activities of Na(+)-K(+)-ATPase and Ca(2+)-ATPase decreased; total peripheral vascular resistance and left ventricular myocardium were progressively increasing. CONCLUSION: Membrane-destabilizing processes and hemodynamic shifts were more expressed in subjects with arterial hypertension working in the duty regimen.

[The enzymatic activity of transmembrane ion transport in the early stages of hypertension]. / Aktivnost' fermentov transmembrannogo transporta ionov na rannikh stadiiakh gipertonicheskoi bolezni.

A study is presented of the activity of Na(+)- K(+)-, Mg2(+)- and Ca2(+)-ATP-ases, lipid spectrum of the erythrocytic membranes and the content of intracellular sodium and potassium in 26 patients with borderline arterial hypertension (BAH) and 41 patients with hypertensive disease, stage I (HD). It was shown that these patients revealed an essential reduction of Na(+)-K+ATP-ase. The diagnostic and differential diagnostic value of these tests is discussed.

[Disorders of the receptor system in regulating extracellular fluid volume in patients with rheumatic heart defects]. / Narusheniia retseptornogo zvena reguliatsii ob'ema vnekletochnoi zhidkosti u bol'nykh revmaticheskimi porokami serdtsa.

The production and urinary excretion of the natriuretic factor and sodium output decreased in patients with rheumatic heart defects as left-atrial dilatation progressed and signs of circulatory insufficiency grew more apparent. It is suggested that prolonged left-atrial dilatation is associated with a fall of volume receptor sensitivity and insufficient left-atrial production of substances activating the natriuretic factor involved in abnormal water-salt metabolism in these patients.