[Effect of therapy with lisinopril on the state of cerebral blood flow in women with hypertension in peri- and postmenopause]. / Vliianie terapii lizinoprilom na sostoianie tserebral'nogo krovotoka u zhenshchin s arterial'noi gipertenzieiv peri- i postmenopauze.

Blood flow in extra and intracranial arteries was assessed by doppler ultrasound in 26 hypertensive women without history of stroke. Studies were performed before treatment, after acute test with lisinopril and in 1 month of therapy with lisinopril. Baseline investigation revealed changes of velocity characteristics of blood flow and resistance indexes indicative of impaired cerebral hemodynamics both at extra- and intracranial level. After treatment with lisinopril signs of improvement of blood flow in extra- and intracranial arteries were found. Most important finding was normalization of ability of extracranial arteries to spasm and dilation presumably associated with restoration of hemodynamic reserve of cerebral vessels.

[Stratification of patients with hypertension and selection of antihypertensive therapy]. / Stratifikatsiia bol'nykh s arterial'noi gipertenziei i vybor antigipertenzivnoi terapii.

Patients with hypertension (78 men, 113 women aged 20-73 years) were stratified according to risk of development of cardiovascular complications. In low and moderate risk patients (n=31) with borderline hypertension, dyslipidemia and pronounced obesity mainly non-drug measures were employed directed at lowering of excess body mass. Medium risk patients (n=25) with isolated hypertension group were treated with angiotensin converting enzyme inhibitors and phenylalkylamine calcium antagonists. High risk patients (n=55) with metabolic syndrome received same antihypertensive drugs as medium risk patients. In very high risk patients (n=79) with diabetes, excessive body mass, dyslipidemia and proteinuria complex therapy consisting of antihypertensive and hypoglycemic drugs and non-drug interventions was used. This risk stratification based management of patients with hypertension on turned out to be highly effective and resulted not only in normalization of blood pressure but also in improvement of carbohydrate and lipid metabolism, lowering of resistance to insulin and excessive body mass, and improvement of renal function.