Aim. To investigate the associations between the severity of carbohydrate metabolism disturbances, arterial hypertension (AH) severity (based on AH stage and 24-hour blood pressure monitoring (BPM) parameters), and lipid profile.
Material and methods. In 403 patients with AH and metabolic syndrome (MS), blood biochemical assay, glucose tolerance test, and 24-hour BMP were performed.
Results. Patients with impaired glucose tolerance (IGT), compared to participants with impaired fasting glycemia (IFG) or particularly to individuals with normal carbohydrate metabolism, demonstrated more severe lipid profile disturbances, more advanced AH stage, and increased mean BP levels, BP load, and BP variability at 24-hour BPM.
Conclusion. IGT, as a more severe variant of carbohydrate metabolism disturbances, could be associated with increased risk of cardiovascular disease and Type 2 diabetes mellitus.

Aim. To assess the associations between the perception of stressful life events, psychological coping (PC) styles, and the progression of arterial hypertension (AH); to identify psychotherapeutic approaches towards blood pressure (BP) correction, based on the perception self-control.
Material and methods. In 3 groups of the patients with AH Stages 1—3, the diagnostics of stress resilience and social readjustment (Holmes and Rahe scale) and the Life Style Index assessment (Plutchik, Kellerman, and Conte scale) were performed.
Results. The study results supported the view on AH progression as a process of decreasing adaptation and inadequate PC (5 PC styles out of 8 were inadequate). No statistically significant difference in PC parameters was observed across AH stages.
Conclusion. The study findings have been used for identification of psychotherapeutic (psychoanalytic) approaches towards BP correction, based on the perception self-control.

Aim. To assess the specifics of 24-hour blood pressure monitoring (BPM) parameters and their association with body mass index (BMI) in patients with arterial hypertension (AH) and obstructive sleep apnoea (OSA) syndrome.
Material and methods. The study included 120 AH patients with BMI under or over 25 kg/m2, who underwent 24-hour BMP and combined monitoring of electrocardiogram (ECG) and breathing.
Results. AH patients with OSA syndrome demonstrated increased mean daytime and nighttime levels of systolic and diastolic BP (SBP, DBP) and a 1,5-fold increase in SBP and DBP pressure load indices. Patients with increased BMI had disturbed circadian BP profile, with reduced mean 24-hour difference, more pronounced for DBP (2,4-fold difference), and an increase in the “over-dipper” prevalence (from 13,3 % to 42,1 %).
Conclusion. The combination of AH, OSA syndrome, and increased BMI substantially affected 24-hour BPM parameters. Increased BMI was associated with disturbed circadian BP profile and increased levels of mean 24-hour BP and nighttime BP

Aim.To identify the optimal treatment tactics in patients with Functional Class (FC) II chronic heart failure (CHF) (NYHA classification) and essential arterial hypertension (EAH), via investigating the effects of different medication classes on regulatory and adaptive status (RAS).
Material and methods.The study included 100 patients with FC II CHF and Stage II EAH, who were randomised into 2 groups. Group I included 53 patients (mean age 52,9±2,3 years) receiving metoprolol succinate (mean dose 97,3±9,5 mg/d). Group II included 47 patients (mean age 57,5±1,3 years) administered quinapril (mean dose 24,7±6,3 mg/d). At baseline and after 6 months of therapy, the following procedures were performed: treadmill test with VO2max assessment; echocardiography; 24-hour blood pressure monitoring; N-terminal pro-brain natriuretic peptide (NT-proBNP) level measurement; and cardio-respiratory synchronism test.
Results.While both medications improved left ventricular (LV) diastolic function, only quinapril demonstrated beneficial effects on LV structure, geometry, and systolic function. Only in Group II, exercise capacity and VO2max increased, RAS improved, and NT-proBNP levels decreased to a greater extent.
Conclusion.Quinapril was more effective than metoprolol succinate in the treatment of patients with FC II CHF and Stage II EAH.

Aim. To investigate the effects of an angiotensin-converting enzyme (ACE) inhibitor fosinopril on the structural and functional parameters of brachial arteries (BA) in patients with essential arterial hypertension (EAH).
Material and methods. The study included 32 EAH patients: 15 men and 17 women aged 27-59 years (mean age 45,6±11,7 years). BA ultrasound and echocardiography (EchoCG) were performed with the use of the Vivid 7 Dimension device (USA). The following parameters of BA remodelling were analysed: intima-media thickness (IMT), lumen diameter (D), and wall-to-lumen (W/L) ratio. BA endotheliumdependent vasodilatation (EDVD) was assessed in the reactive hyperemia test. Central hemodynamic parameters were also assessed.
Results. In EAH patients, the six-month fosinopril treatment was associated with BA IMT reduction, but not with substantial intraluminal diameter changes, or increased endothelium-dependent vasodilatation.
Conclusion. Among EAH patients, an ACE inhibitor fosinopril demonstrated a marked improvement in BA structural and functional parameters.

Aim. To analyze the results of different tactics of single-stent endovascular treatment among patients with coronary heart disease (CHD) and coronary artery bifurcation lesions (CABL).
Material and methods. The study included 135 CHD patients with CABL. All participants were divided into 2 groups: Group I (n=77; 58,3 %) consisted of patients who underwent coronary artery (CA) main branch (MB) stenting and subsequent kissing balloon angioplasty of a CA side branch (SB). Group II (n=55) included patients with “genuine” CABL, who underwent only MB stenting with SB protection, but without SB balloon angioplasty.
Results. In all 132 CABL patients, drug-eluting stents were successfully implanted, with technical effectiveness of 100 % and in-hospital survival of 100 %. Clinical outcomes were similar in both groups, with no major cardiovascular events registered. At the same time, such an important angiographic index as SB diameter was significantly higher in Group I, compared to Group II. At later stages, Group II patients required SB angioplasty and demonstrated habitual angina symptoms, ischemic electrocardiographic (ECG) changes, and slow SB blood flow (TIMI grade <III) after CA MB stenting.
Conclusion. MB stenting of CA bifurcation without SB kissing balloon angioplasty cannot be recommended to all CABL patients. Development of habitual angina symptoms, ischemic ECG changes, and slow SB blood flow (TIMI grade <III) often requires subsequent SB kissing balloon angioplasty.

Aim. To identify the value of selected parameters and integral indices of treadmill test (TT), such as Duke Treadmill Score (DTS), Centre for Preventive Medicine index (CPMI), and modified CPMI, in the assessment of cardiovascular complication (CVC) risk among patients with chronic coronary heart disease (CCHD).
Material and methods. The study included all consecutive patients with the admission diagnosis of CCHD (n=260), who underwent coronary angiography (CAG) and TT in the period from January 1st 2004 to December 31st 2007, and were permanent residents of Moscow City or Moscow Region. Primary end-point was death from all causes; non-fatal CVC included acute myocardial infarction, acute cerebrovascular accident, and revascularization (percutaneous coronary intervention or coronary artery bypass graft surgery).
Results. The mean time to the development of primary end-point was 3,2 years; it total, it was registered in 71 patients (32,0 %). The incidence of primary end-point was higher in patients with ST segment depression ≥1 mm at TT, positive TT result, or chest pain development during the test. Achievement of target heart rate and TT time ≥12 minutes was associated with a better prognosis. In patients with high and intermediate risk by DTS and CPMI, the incidence of primary end-point was higher than in patients with low risk. Modified CPMI demonstrated high correlation with the primary end-point.
Conclusion. The highest prognostic value in the assessment of the risk of CCHD complications was demonstrated by TT result, ST segment depression ≥1 mm, TT time, and chronotropic TT response. The role of CPMI and modified CPMI as predictors of CVC risk in CCHD patients was assessed.

Aim. To identify the specifics of acute myocardial infarction (AMI) clinical course and to study the association between clinical outcomes and hospital admission time among elderly patients from Central Asia.
Material and methods. In total, 508 AMI patients were divided into the main group (MG), which included 298 men and women aged over 65 years, and the control group (CG; n=210). The analysed parameters included mean time between AMI onset and hospital admission; percentage of patients hospitalised within first 6 hours; percentage of patients administered streptokinase; streptokinase effectiveness; clinical course of AMI; and in-hospital outcomes.
Results. Mean hospital admission time was significantly higher in the MG, compared to the CG: 1220±165 vs. 977±88 minutes (p<0,05). Out of 188 MG patients with ST segment elevation, thrombolytic therapy (TLT) was administered to 14,3 %; in the CG (149 patients with ST segment elevation), the respective percentage was 25,5 %. Clinical course of AMI was similar in both groups. However, the MG was characterised by a significantly higher risk of death (9,4 % vs. 2,86 %; F=0,001; OR 3,53, 95 % CI 1,43—8,67), acute heart failure (33,89 % vs. 21,9 %; F=0,001; OR 1,83, 95 % CI 1,22—2,74), or chronic heart failure (41,31 % vs. 24,76 %; F=0,000; OR 2,62, 95 % CI 1,78—3,86).
Conclusion. Elderly patients faced a lower chance of myocardial reperfusion, due to later hospital admission and lower TLT effectiveness, and, as a result, had a higher risk of heart failure.

Aim. To study the effects of mildronate, as a component of complex therapy, on left ventricular (LV) systolic and diastolic function and exercise capacity (EC) in myocardial infarction (MI) patients undergoing post-hospital rehabilitation.
Material and methods. This open, randomized study included 2 groups (50 men in each group; mean age 53,8±2,7 years): the control group (CG) and the main group (MG), which suffered MI in 4 weeks prior to the study inclusion (70% with Q-wave MI and 30% with transmural MI), and had stable post-infarction angina, Functional Class (FC) II, and ejection fraction (EF) >35%. In both groups, pharmaceutical therapy included metoprolol (75-150 mg/d), isosorbide mononitrate (40 mg/d), aspirin (100 mg/d), clopidogrel (75 mg/d), atorvastatin (20-40 mg/d), and enalapril (2,5-5 mg/d). The MG patients additionally received mildronate (1,5 g/d) for 3 months. The follow-up period was 1 year. EC was assessed using veloergometry (VEM) and 6-minute walk test (6MWT). LV systolic and diastolic function was assessed with the use of Doppler echocardiography. The following parameters were calculated: EF, DTE, LV isovolumetric relaxation time (IVRT), and enddiastolic pressure (EDP). Two types of diastolic dysfunction (DD) were defined: Type I (E/A <1; DTE >0,220 ms) and Type II (E/A >1,5; DTE <0,150 ms).
Results. Mildronate therapy facilitated EC recovery, improved VEM threshold capacity, and increased 6MWT velocity and distance. In addition, mildronate improved LV systolic and diastolic function in both types of DD, by increasing EF and reducing EDP. In type I DD, E/A and IVRT increased, while DTE decreased. In Type II DD, the changes were also positive, but different: E/A decreased, while IVRT increased.
Conclusion. Adding mildronate to the complex therapy of MI patients at the post-hospital rehabilitation stage facilitates EC improvement and benefits LV systolic and diastolic function.

Currently, beta-adrenoblockers (β-AB) are regarded as one of the major medication classes in the treatment of patients with chronic heart failure (CHF). In several international studies, β -AB therapy of CHF patients was associated with reduced levels of haemoglobin (Hb) and development of new anaemia cases. Anaemia is known as an adverse prognostic factor in CHF.
Aim. To study the effects of β -AB therapy on the anaemia clinical course among CHF patients.
Material and methods. The study included 90 ambulatory patients with Functional Class (FC) II-IV CHF and anaemia. The participants were divided into 3 equally sized groups (n=30 per group) and treated with carvedilol, metoprolol, or nebivolol for 6 months.
Results. By the end of the follow-up, baseline Hb levels increased in the nebivolol group (p=0,028), and were also significantly higher than in the other two groups. In the carvedilol group, the levels of haematocrit (Ht) and glomerular filtration rate (GFR) significantly decreased (p=0,017 and 0,06, respectively). In the metoprolol group, no substantial changes of laboratory parameters were observed. The maximal reduction in baseline CHF FC was registered in the patients receiving nebivolol (p=0,037). A significant improvement in myocardial contractility, based on the echocardiography data, was registered in the carvedilol and nebivolol groups.
Conclusion. Nebivolol therapy was associated with a significantly more pronounced reduction in pro-BNP levels, compared to carvedilol or metoprolol treatment (p<0,001). The nebivolol group also demonstrated the most pronounced improvement in quality of life of CHF patients (p<0,001). These findings suggest that nebivolol could be recommended as a medication of choice in patients with CHF and anaemia.

Aim. To investigate the association between periodontal hemodynamic disturbances and systemic endothelial dysfunction (ED); to assess the effectiveness of various toothpastes for periodontal disease prevention in patients with nicotine dependence.
Material and methods. In total, 120 young individuals aged 22—28 years were divided into 2 groups, according to the presence or absence of nicotine dependence. All participants underwent ED assessment with the EndoPAT device. Microcirculation (MC) was assessed with the high-frequency Doppler ultrasound system MinimaxDoppler-K. Patients with nicotine dependence were divided into 2 subgroups. Subgroup A was recommended to use the R.O.C.S. toothpaste Anti-Tobacco (WDS Laboratories) twice a day, while Subgroup B participants were recommended to use the toothpaste Colgate Advanced Whitening with polishing micro-crystals (ColgatePalmolive Poland) twice a day.
Results. Significant between-group differences were observed for reactive hyperemia index and augmentation index. ED severity was higher in smoking participants. Velocity and volume parameters of periodontal MC were lower in smokers. The use of each specialized toothpaste was associated with improved periodontal MC, decreased prevalence of periodontal pathology-related complaints, reduced periodontal pocket depth, and decreased periodontal index values; however, the Anti-Tobacco toothpaste was more effective.
Conclusion. Young smokers demonstrated а more severe ED and disturbed periodontal MC, which manifested in a more advanced periodontal disease.

Cardiovascular risk (CVR) stratification plays an important role in the primary prevention of atherosclerosis and associated disorders. The standard scales for CVR assessment (Framingham scale, SCORE scale, etc.) are focused on a limited number of traditional risk factors (RFs) and, therefore, neither produce precise individual risk estimates, nor increase the effectiveness of preventive interventions. One of the methods for CVR assessment optimisation is the diagnostics of subclinical atherosclerosis, based on the direct visualisation of preclinical atherosclerotic changes in arterial wall. Extracranial carotid artery (CA) ultrasound and assessment of the intima-media thickness (IMT) index or atherosclerotic plaque volume (PV) is an important method of the preclinical atherosclerosis diagnostics. The review discusses pathogenetic mechanisms of IMT increase, the standards of ultrasound IMT assessment and its interpretation, and the role of the information obtained for optimization of the CVR evaluation.

Metabolic syndrome (MS) has recently gained more clinical attention due to its increasing prevalence and association with adverse prognosis. One of the main pathological features of MS is endothelial dysfunction. It plays a key role in the development of cardiovascular MS complications. Therefore, effective therapy aimed at the normalization of endothelial function should be a part of pathogenetic management of MS patients.

The paper discusses the role of scientific medical information and its impact indicators (researcher’s publishing activity, citation index, impact factor, Hirsch index, etc.). The sources of these indicators are specified.