Aim. To investigate real-word antihypertensive drug therapy in Tomsk City and Region.
Material and methods. In January-June 2004, non-organized population of Tomsk City and Region was examined, according to the Regional Program «Arterial Hypertension Prevention and Treatment in Tomsk Region, 2004-2008». The examination included anthropometry, blood pressure measurement, and questionnaire survey. In total, 943 people aged 15-89 (472 in the region, 471 – in the city) were examined.
Results. In Tomsk City and Region, 39.4% of adult population suffered from arterial hypertension (AH). Among AH patients, 78.7% received various antihypertensive agents: one drug – 44.4%; two drugs – 36.5%; three drugs or more – 19.1%. The most frequently prescribed agents, as monotherapy or a part of combined therapy, were diuretics (47.8%) and ACE inhibitors (46.2%).
Conclusion. AH prevalence in Tomsk Region is similar to that in Russian general population. Real-world use of antihypertensive agents does not conflict with the latest recommendations of the Society of Cardiology of the Russian Federation. The patients must be informed more actively about the need for regular, doctor-controlled intake of antihypertensive medications. Various educational programs for hypertensive patients should be developed and implemented.

Aim. To study the prevalence of arterial hypertension (AH) risk factors (RF), and their association, in Kemerovo City penitentiary system (KCPS) personnel.
Material and methods. In total, 248 individuals (73% males, 27% females), aged 20-39 (mean age 35.4±0.4 years), were examined. AH stage was assessed, according to WHO criteria (1999). Body mass index (BMI), waist and hips circumference (WC, HC), smoking index, alcohol intake, lipid profile, and psychological status (by Multiple Personality Assessment method) were evaluated. Night-shift work and physical activity were also assessed.
Results. Prevalence of high blood pressure (BP) in KCPS personnel was 41.5% in persons aged under 40. BP level significantly (p<0.001) correlated with BMI, WC, serum level of total cholesterol (TCH) (p<0.001), and age (p<0.05). Systolic BP level correlated with BMI (r=1.83; р=0.04), age (r=3.12; р=0.05), WC (r=0.58; р=0.01), levels of TCH (r=2.9; р=0.05) and triglycerides (TG) (r=3.48; р=0.05). Diastolic BP independently correlated with age (r=3.06; р=0.05), height (r=0.36; р=0.003), BMI (r=1.58; р=0.03), WC (r=0.44; р=0.01), and TCH concentration (r=2.99; р=0.03).
Conclusion. Prevalence of high BP in male KCPS personnel was greater than standard rates; office BP independently correlated with BMI, WC, age, serum levels of TCH and TG. Arterial hypertension correlated with increased BMI and abdominal obesity significantly more often.

Aim. To study correlations between blood pressure (BP) level and autonomous dysfunction symptoms.
Material and methods. The study included 84 males aged 18-45, with mean systolic BP (SBP) level of 110-139 mm Hg, and diastolic BP (DBP) level of 70-89 mm Hg. The standard physical and instrumental examination, 24-hour BP monitoring, and modified orthostatic test were performed.
Results. In 80% of the patients with high normal (HN) BP, there were some clinical symptoms observed, e.g. headache and vertigo. Circadian BP profile was characterized by increased load index and elevated mean BP during all day, comparing to normotensive subjects. HN BP group was heterogeneous: in 42.3% of cases, BP variability was increased, nighttime BP was abnormally decreased, and hemodynamics reaction in orthostatic test was exaggerated.
Conclusion. In young males with HN BP, autonomous dysfunction symptoms, associated with increased BP variability and abnormally increased nighttime BP drop, can be regarded as a complex of early cardiovascular disease predictors.

Aim. To study parameters of signal-averaged electrocardiography (SA-ECG) in patients with essential arterial hypertension (EAH), according to structural and functional cardiac disturbances.
Material and methods. In total, 89 EAH patients were examined: 47 males and 39 females (mean age 51.5±7.2 years), including 24 patients with Stage I EAH, and 62 Р with Stage II EAH.
Results. Late ventricular potentials (LVP) were registered in 29 EAH patients (33.7%). Patients with LVP had more advanced left ventricular and atrial dilatation (LV, LA). This resulted in increased LV end-systolic size, end-diastolic volume and size, LA size, compared to LVP-free participants. EAH patients with LVP had more progressed LV hypertrophy (LVH): increased thickness of interventricular septum, posterior wall, myocardial mass index. Assessing SA-ECG parameters in EAH patients with various LV remodeling types, the authors observed that LVP were more common for patients with eccentric LVH.

Aim. To study the effects of various risk factors (RF) and circadian blood pressure profile (BPP) on pathogenesis of various ischemic stroke (S) subtypes.
Material and methods. In total, 60 ischemic stroke patients aged 38-68 years were examined. All participants underwent 24-hour BP monitoring (BPM).
Results. Arterial hypertension (AH) was diagnosed in all participants. AH crises were more frequent in patients with lacunar S subtype. By night BP decrease, 36.6% of the patients were identified as dippers, 50% - non-dippers, 6.6% - night-peakers, and 6.67% - over-dippers. Too low and too great BP decline (non-dippers, over-dippers) were RF for atherotrombotic, cardioembolic, and lacunar S. Maximal speed of morning BP surge was typical for patients with lacunar S, non-dippers, and over-dippers.
Conclusion. Ischemic S usually happened in the morning; lacunar S developed significantly more often at 4-10 am. In males, the most important risk factor was age, in females Р compromised family history, and left ventricular hypertrophy. Circadian BPP disturbances were RF for various S subtypes.

Aim. During enalapril therapy in essential arterial hypertension (EAH) patients, to assess correction of the factors determining arterial thrombosis and inflammatory changes in arterial wall.
Material and methods. The study included 21 males with Stage II EAH. The authors analyzed cardiac ultrasound data, blood rheology, white blood cell (WBC) functional activity, plasma levels of von Willebrand factor (vWF) and intercellular adhesion molecules (ICAM). The second examination was performed after 24-week enalapril therapy (10-40 mg/d).
Results. Enalapril therapy was associated with blood rheology improvement, WBC functional activity decrease, decline in vWF and ICAM plasma levels. Enalapril antihypertensive effect was combined with left ventricular hypertrophy (LVH) regression.
Conclusion. In EAH patients, long-term enalapril therapy was associated with LVH regression, thrombo- and atherogenesis suppression.

Aim. To study antihypertensive and anti-ischemic effects on structural and functional heart status, and assess treatment safety for combination of dihydropyridine and non-dihydropyridine calcium antagonists (CA).
Material and methods. The authors examined 31 patients with Stage II-III, level II arterial hypertension (AH) (Society of Cardiology of the Russian Federation, 2001), and coronary heart disease (CHD), effort angina, Functional Class (FC) II-III. Twenty-four-hour electrocardiography (ECG) and blood pressure (BP) monitoring, Doppler echocardiography (EchoCG) were performed. Combined therapy with amlodipine and verapamil retard lasted for 24 weeks.
Results. During the treatment, in 77.4% of the patients, complete antihypertensive effect (BP<140/90 mm Hg) was observed; in 22.6%, this effect was partial (diastolic BP decrease by 10 mm Hg). Mean decrease in left ventricular myocardial mass index was 24.9±2.3 g/m2 (p<0.01). Diastolic function improved: early and late flow velocity ratio (E/A) increased by 10.3% (p<0.05); isovolumic relaxation time reduced by 13.6% (p<0.01). Maximal depth of ST segment depression decreased from 2.3±0.2 to 1.5±0.1 mm. Duration and frequency of painless myocardial ischemia decreased, too. Adverse effect rate was by 1.5-4 times lower than for monotherapy.
Conclusion. Combination of dihydropyridine and non-dihydropyridine CA demonstrated its antihypertensive, anti-ischemic, and cardioprotective effects, and was well tolerated.

Aim. To assess the role of acute nitroglycerin test (ANT) for predicting perindopril therapy effectiveness in patients with coronary heart disease (CHD) and chronic heart failure (CHF).
Material and methods. In 127 CHD and CHF patients, assessment of left and right ventricular (LV, RV) contractility was performed, by balanced biventricular radioventriculography and segmental histogram analysis, according to standard protocol. The assessment was performed at baseline ANT and after 6 months of perindopril therapy. By ejection fraction (EF) figures, all participants were divided into two groups: Group I consisted of 89 patients with CHD an Functional Class (FC) II-III CHF, LVEF>40%; Group II included 38 CHD patients with FC III-IV CHF, LVEF<40%.
Results. In ANT, Group I demonstrated significant increase in total LVEF, from 62.5±8.4% to 68.0±8.2%, some increase in RVEF, and significant decrease in end-diastolic and systolic volumes (EDV, ESV) - by 21.4 and 40.1%, respectively (р<0.05). In Group II, ANT was associated with increase in total LVEF, from 22.6±10.8% to 30.7±15.3% (р<0.02); RVEF increased from 30.4±13.3% to 37.2±13.8% (р<0.05); EDV and ESV did not change significantly. In both groups, zones of local dyskinesia Р hypo- and akynesia Р were identified. During ANT, the number of normokynetic zones increased, the number of hypokinetic zones decreased, especially in LV anteroseptal area. In patients with EF<40%, the number of LV lateral wall akynetic zones reduced significantly. After 6-month perindorpil treatment, local EF increased in LV lateral wall segments (Group I) and lateral wall (Group II), that correlated with substantial total EF increase.
Conclusion. Improvement of local contractility in ANT was due to LV and RV zones with reversible dysfunction. Improved total and local contractility in ACT gives a chance to assess perindopril effectiveness in patients with CHD and FC II-IV CHF.

Aim. To investigate the effects of electromagnetic terahertz waves at NO MSIP (molecular specter of radiation and absorption), 240 Hz, on platelet functional activity Р in natural electromagnetic field, as well as in crossed magnetic and electric fields among unstable angina patients.
Material and methods. This in vitro study was performed on samples of platelet-enriched plasma from 120 unstable angina patients. The study of terahertz waves and platelets interaction at NO MSRA specter, 240 GHz, was performed with original quasi-optic SW generator of determined noises (CRIMD, Saratov). Functional activity of platelets (activation and aggregation) was measured by laser aggregation analyzer (Biola-230 Ltd.).
Results. After in-vitro radiation of platelet-enriched plasma from unstable angina patients, at NO MSRA frequency, 240 GHz, disturbed platelet aggregation activity was normalized.
Conclusion. Therefore, terahertz waves, at NO frequency, 240 GHz, substantially decreased elevated aggregation activity of the platelets from unstable angina patients.

Aim. To compare alteplase (AL) and streptokinase (SK) effectiveness in patients with various severity of acute myocardial infarction (AMI).
Material and methods. In retrospective analysis, 650 AMI patients were divided into three groups. Group I consisted of 183 subjects administered AL, Group II Р 232 individuals receiving SK, and Group III - 235 participants not administered any thrombolytic therapy (TLT). Each group was divided into three subgroups, according to Peel coronary prognostic index (CPI). Subgroup A included patients with Peel CPI of 1-8 points, Subgroup B Р 9-16 points, and subgroup C Р more than 16 points. Clinical outcomes of patients receiving AL, SK, or no TLT, were compared for all subgroups.
Results. In Subgroup C, lethality in AL therapy (28.6%) was significantly lower than in SK therapy (50.0%) or no TLT (45.3%) (p<0.05). In subgroup B, lethality was lower for both AL and SK treatment (2.6% and 2.3%, respectively), comparing to no TLT (10.6%) (p<0.05). In this subgroup, both thrombolytic agents significantly decreased heart failure (HF) incidence. In subgroup A, AL more effectively than SK or no TLT reduced risk of HF, post-AMI angina, not affecting lethality or recurrent MI rates.
Conclusion. AMI patients with low or high risk by Peel CPI should be administered AL. SK could be recommended for intermediate-risk AMI patients.

Aim. To investigate psychosocial factors and personality traits affecting the effectiveness of myocardial infarction (MI) rehabilitation programs.
Material and methods. One hundred males with Q-wave MI, aged 35-73 (mean age 51.6±1.7 years), were examined. Standard clinical examination was combined with psychoemotional status assessment (Luscher test, SMIL questionnaire, Spielberger-Khanin State-Trait Anxiety Inventory, Jenkins Activity Survey on coronary behavior type, quality-of-life scales). One-half of the participants attended Coronary Club sessions, to modify behavioral risk factors for coronary heart disease.
Results. The results obtained demonstrate high effectiveness of behavioral rehabilitation programs in MI patients. People with Type A coronary behavior had more complicated post-MI period, and more evident effectiveness of rehabilitation programs.
Conclusion. Behavioral programs should be included into early complex rehabilitation of MI patients.

Aim. To study clinical efficacy of a new, class III, antiarrhythmic agent, nibentan, in various supraventricular (SV) cardiac arrythmias.
Material and methods. In total, 153 patients with atrial fibrillation, atrial flutter, or SV tachycardia were examined. Electrocardiography monitoring, echocardiography, electrolyte balance assessment, biochemical blood assay were performed. Left ventricular (LV) kinetics and perfusion was measured by myocardial computer scintigraphy method. The results were processed with 4DM spect program.
Results. Nibentan demonstrated high antiarrhythmic activity in various SV cardiac arrhythmias No significant effects on central hemodynamics and LV myocardial perfusion were observed.
Conclusion. In this trial, a new medication, nibentan, demonstrated the qualities of a true class III antiarrhythmic agent.

Aim. To study blood lipid profile and cardiovascular disease (CVD) in family history of young people with various health status.
Material and methods. The study included 80 people aged 18-29 (mean age 22.3±0.4 years). In all participants, health status screening was performed. According to adaptation potential level, three groups were identified: with good (I), fair (II), and poor (III) adaptation potential. The following parameters of lipidogram were registered: total cholesterol (TCH), high-density lipoprotein cholesterol (HDL-CH), low- and very low-density lipoprotein cholesterol (LDL-CH, VLDL-CH), triglycerides (TG); atherogenicity index (AI) was also calculated. In participants with dyslipoproteinemia (DLP), detailed information on CVD in family history was collected.
Results. Adaptation potential was reduced in 56 persons (70%). Abnormal lipidogram (TCH >5.88 mmol/l, LDLCH >3.83 mol/l, and AI >3 U) was observed in 4 participants from Group III (19%), including 3 individuals (14.3%) with TG >1.75 mmol/l (equivalent of Type IIa and III DLP). For all three groups, differences in TCH, LDL-CH, and AI levels were statistically significant.
Conclusion. Even in young people, initial symptoms of lipid metabolism abnormality were detected, including hyper- and dyslipidemia. Abnormal lipid metabolism was observed only in young males with poor adaptation potential. Participants with disturbed lipid metabolism had CVD in family history.

Aim. To assess functional cardiohemodynamics status in patients with thoracic dysplastic scoliosis, by Doppler echocardiography (DEchoCG) and diagnose the most valuable early signs of «kyphoscoliotic heart» development.
Material and methods. The study included 90 adolescent boys and girls, with Stage II-IV scoliosis, aged 13-18. DEchoCG was performed by ТMegasУ device (Italy), according to standard protocol. Pulmonary hemodynamics and right heart diastolic function in scoliotic adolescents were examined.
Results. In scoliotic adolescents, increase in systolic, diastolic, and mean hemodynamic pressure in pulmonary artery was registered. These patients also had increased right ventricular wall thickness and chamber size; velocity and temporal characteristics of diastolic tricuspidal blood flow were disturbed.
Conclusion. In severe thoracic scoliosis, pulmonary hypertension and right ventricular myocardial dysfunction «kyphoscoliotic heart» develops at young age.

Aim. To assess heterogeneous vasodilatation mechanisms in coronary heart disease (CHD) patients with Type 2 diabetes mellitus (DM2) and arterial hypertension (AH).
Material and methods. In total, 62 DM2 patients aged 41-60 years were examined. By DM2 compensation, all participants were divided into two groups: Group I (n=37) with compensated DM2, and Group 2 (n=25) with DM2 decompensation. Age- and gender-matched control group consisted of 30 relatively healthy volunteers. Endothelium-dependent vasodilatation (EDVD) of brachial artery (BA) was measured by ultrasound scanning and flow dopplerography, in reactive hyperemia test. Shear stress and endothelium sensitivity to shear stress were calculated. Endothelium-independent vasodilatation (EIVD) was assessed in sublingual nitroglycerin test.
Results. In decompensated DM2 patients, even at rest, BA blood flow and elasticity were reduced. In Celermajer D.S. test, BA diameter increase was twice as low as in healthy individuals. Shear stress endothelial sensitivity was reduced in DM2 participants. In diabetic patients with carotid atherosclerosis, BA diameter increase in nitroglycerine test was significantly lower than in participants without peripheral artery atherosclerosis.
Conclusion. In DM2 patients, atherogenic lipid metabolism disturbances resulted in reduced endothelial sensitivity to shear stress, and endothelial dysfunction in middle-size arteries. In inadequate hyperglycemia compensation, endothelial dysfunction was observed more often.

The article contains literature review on arterial hypertension (AH) pathogenesis in climacteric women, and the role of humoral systems, in particular, renin-angiotensin-aldosterone system, in AH development among these patients. Pathogenetic features of antihypertensive therapy in climacteric women are discussed.

This review contains the results of the studies in pathophysiological basis of endothelial function (EF), and clinical methods for its assessment. Main neurohormonal mechanisms of EF regulation in healthy persons are compared. Diagnostic and prognostic value of EF disturbances, as cardiovascular event predictors, is analyzed in details. Modern data on pharmaceutical and non-pharmaceutical EF correction are presented. The authors also deliver a hypothesis on genetic causes for EF disturbances in humans.