Сlinical and population studies have shown that elevated heart rate (HR) in patients with arterial hypertension significantly increases the risk of organ damage, development of cardiovascular events and overall mortality. Therefore, measurement of resting HR should be a component of standard hypertensive patients examination. This simple parameter was shown to reliably reflect sympathetic nervous system activity. A cutoff point for resting HR over 80 beats per minute (bpm) has been proposed to be a marker of sympathetic overdrive and an independent cardiovascular risk factor. However, the rationale and target for HR reduction in hypertension without cardiovascular diseases are still controversial. It is necessary to take into account the tolerance of tachycardia, blood pressure level, the HR level and comorbidity before starting HR reduction therapy. Increased resting HR may be a clinical sign of sympathetic overdrive, but also a symptom of anemia, thyrotoxicosis, hypovolemia, chronic heart failure, and other conditions. It is also necessary to consider patient’s metabolic status and lifestyle. Thе review summarizes expert council opinion on the management of patients with hypertension and HR over 80 bpm, including the issue of beta-blocker indications.

High NaCl content in food promotes hypervolemia and increased blood pressure (BP). Sensitivity to NaCl was found in 26 % of normotensive human population and in 51 % of hypertensive patients. The aim of the work was to evaluate the impact of renal denervation (RD) on BP in normotensive and hypertensive salt-sensitive rats (Dahl-S and DOCA) consuming a diet enriched with NaCl using meta-analysis. Materials and methods. The meta-analysis included eight studies, which investigated normotensive animals without indicating increased sensitivity to salt, 9 studies which used Dahl-S rats (genetic abnormalities are associated with extensive kidney damage and increased BP with a high-salt diet), and 12 studies which assessed rats with the DOCA model (administration of deoxycorticosterone acetate to normotensive rats causes hypervolemia and increased BP with a high-salt diet). Results. High-salt diet induced severe hypertension in Dahl-S rats even with two kidneys and in DOCA rats with one kidney. According to the results of meta-analysis, total bilateral RD decreased BP by 3–6 % in normotensive, Dahl-S and DOCA rats with two kidneys kept on a high-salt diet. The maximum hypotensive effect of RD (9–12 %) was observed in one-kidney rats with DOCA-salt hypertension. RD did not reduce the “white coat” syndrome in the studied models, but the final conclusion about the effect of RD on BP during emotional stress cannot be made due to the difference in experimental methods and the small number of studies using telemetric BP measurement. Preliminary RD significantly inhibited the development of DOCA-salt, but not Dahl-S hypertension. In normotensive animals and in Dahl-S rats, the RD effect did not depend on the duration of the high-salt diet. The longer DOCA-salt hypertension lasted before RD, the lesser the antihypertensive effect of RD. In Dahl-S rats, sodium excretion decreased during the first 3 weeks after RD, and increased after 4–6 weeks. However, there is no convincing evidence of changes in sodium excretion after RD in rats with DOCA-salt hypertension. Conclusions. With a high-salt diet in normotensive rats and in animals with salt-sensitive hypertension, total RD reduces the baseline BP level. The antihypertensive effect of total RD is greater in DOCA rats compared to Dahl-S rats kept on a high-salt diet.

This article discusses the main issues related to the choice of tactics for the treatment of patients with fibromuscular dysplasia of the renal arteries. The key messages of the Russian, European and American consensus papers are presented. The current concepts of the etiology, risk factors, genetic predictors, as well as management approaches, including surgical treatment, are highlighted.

Objective. To evaluate noninvasive parameters of myocardial work in patients with preserved left ventricular ejection fraction (LVEF) 6 months after myocardial infarction (MI), depending on the presence/absence of heart failure (HF) using the HFA-PEFF algorithm (the Heart Failure Association Score for heart failure with preserved ejection fraction). Materials and methods. We included 90 patients who had suffered MI 24 weeks before screening and had LVEF ≥ 50 % at the time of inclusion. The average age of the subjects was 58 (53; 61) years. Echocardiography was performed using Vivid E95 GE Healthcare device (USA). The global longitudinal strain (GLS), global work index (GWI), global constructive (GCW) and wasted work (GWW), and global work efficiency (GWE) were evaluated. Following the HFA-PEFF algorithm, the score was calculated: < 2 points indicated that the diagnosis of HFpEF could be excluded, in case of ≥ 5 points the diagnosis was considered confirmed, and 2–4 points indicated an uncertain result. Results. The 1^st group with a low probability of HFpEF included 17 (19 %) people; the 2^nd group — 47 (52 %) subjects with intermediate probability of HFpEF; the 3^rd group included 26 (29 %) people with highly probable/confirmed HFpEF (≥ 5 points). Lower values of GWE, GCW, and GWI were found after 6 months in patients with confirmed HFpEF compared with group 1. Dynamic follow-up showed improvement in GWI within 6 months due to an increase in GCW in patients in the group with unlikely HFpEF. GWI, GCW and GWE had high sensitivity for the detection of highly probable/confirmed HFpEF. The threshold value for GWE was 93,5 % (sensitivity 90 %; specificity 70 %, NPV 85 %), for GWI — 1420 mmHg % (sensitivity 90 %; specificity 80 %, NPV 88 %), and for GCW — 1777 mmHg % (sensitivity 85 %; specificity 70 %, NPV 84 %). Conclusion. The parameters of the myocardial work have diagnostic significance in relation to the exclusion of HFpEF in patients who have suffered MI.

Objective. The aim of the study was to identify the features of the daily blood pressure (BP) profile in patients with arterial hypertension (HTN), depending on the presence of chronic heart failure (CHF) and senile asthenia syndrome (SAS). Design and methods. In total, 320 respondents with HTN (56,9 % of women and 43,1 % of men, average age 85,8 ± 4,5 years) were divided into four groups: group 1A — patients with HTN, SAS and CHF (n = 84), group 1B — patients with HTN, CSA without CHF (n = 77), group 2A —patients with HTN, CHF without SAS (n = 84), group 2B — patients with HTN without CHF and without SAS (n = 75). The Age is not a Hindrance questionnaire was used to diagnose SAS and a comprehensive geriatric assessment was performed. All patients underwent ambulatory blood pressure monitoring (ABPM) and the following parameters of blood pressure (BP) were assessed: the average daily, night, daytime indicators of systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse blood pressure (PBP), as well as their variability, the degree of nocturnal BP decrease and BP load indices. Results. In patients with HTN without SAS, the presence of CHF led to significantly lower values of SBP and DBP at all time intervals (p < 0,005), lower values of the SBP time index(s) per day (p = 0.,07) and night (p < 0,001), as well as the SBP area index (S) (p < 0,001), a significantly higher percentage of “dipper” cases by SBP (p < 0,001), a lower percentage of “non-dippers” (p < 0,001) and “night-peakers” by SBP (p = 0,046) compared with HTN patients without SAS and CHF. In the presence of SAS, patients with HTN without CHF, compared with HTN patients without SAS and CHF, also had lower values of SBP and DBP at all time intervals (p < 0,005), BP load indicators (and SBP per day (p < 0,001) and night (p < 0,001), SBP load index (p < 0,001)). In addition, higher SBP variability was observed during the day (p = 0,001) and at night (p < 0,001). The following features are typical for patients with HTN and SAS: a significant increase in the percentage of “dippers” by SBP (p = 0,004), a decrease in the percentage of “non-dippers” (p = 0,002), and a greater percentage of patients with excessive decrease in SBP at night (“over-dipper”) (p = 0,038). Conclusions. Our study provided information about ABPM parameters in hypertensive elderly patients aged 80 years and older with CHF only, SAS only and with coexisting CHF and SAS.

Background. Hypertension is a silent killer which, if not treated properly, can result in cardiovascular complications, including lethal events. Many efforts have been made, but the behavior of hypertensive patients to prevent cardiovascular complications in society continues to be a challenge. Objective. This study aims to develop a health behavior framework model based on transcultural nursing for preventing cardiovascular complications in hypertensive patients in the community. Method. This is a cross-sectional study. A total of 130 respondents who met the inclusion criteria were involved in this research. The development model is proposed with seven variables, namely patient factors, cultural factors, health services factors, maintenance, negotiation, restructuring, and prevention of cardiovascular complications. Data was collected using a questionnaire that had been tested for validity and reliability. Data analysis was carried out using the Structural Equation Modeling - Partial Least Square (SEM-PLS) technique. Results. Based on the R-Sqaure test, it was found that patient factors, cultural factors and health service factors contributed 50,4% to maintenance, 34,7% to negotiation, 23,3% to restructuring. Furthermore, maintenance, negotiation, and restructuring contributed 58,7% to prevention of cardiovascular complications in hypertensive patients in the community. The results of the Q2 predictive relevance test (Q-Square) found that the Q2 predictive relevance value was > 0. Conclusion. Patient factors, cultural factors, and health service factors influence hypertensive patients to perform maintenance, negotiation, and restructuring in implementing preventive cardiovascular measures in the community. The health behavior model that was successfully built in this study has a good predictive relevance value, meaning that this model is relevant and promising to be applied in overcoming the problems of hypertensive patients in carrying out preventive measures for cardiovascular complications in the community.

Arterial hypertension (HTN) remains a global medical and social problem, significantly affecting cardiovascular morbidity and mortality. Detailed study of mechanical and functional changes in the arterial wall associated with age has led to the development of the concepts of Early Vascular Aging (EVA syndrome), Healthy Vascular Aging (HVA) and SUPERNOrmal Vascular Aging (SUPERNOVA). Identification of predictors and pathogenetic mechanisms of the phenotypes formation, as well as determinants of arterial stiffness progression, allows developing preventive and therapeutic strategies to reduce mortality from cardiovascular diseases. At the same time, it is no less important to isolate patients with already formed arterial rigidity and, as a consequence, isolated systolic arterial hypertension (ISAH) into a separate group due to the need to optimize the treatment of this cohort in order to slow down the processes of increasing arterial stiffness and minimize the undesirable effects of hypoperfusion. Thus, the purpose of this literature review was to systematize the accumulated knowledge about the possibilities of slowing down the processes of vascular aging, as well as tools to improve the effectiveness and safety of treatment in the group of patients with ISAH. The article presents a clinical observation of 44 patients with ISAH who were treated at the Omsk Region Budgetary Healthcare Institution “Clinical Cardiology Dispensary” and received a fixed combination of amlodipine/indapamide. By the end of the observation period, high adherence, tolerability and effectiveness of this therapy were observed, as well as a trend towards a decrease in arterial stiffness, assessed by the cardio-ankle vascular index (CAVI). However, there is a need for further studies to stratify patients in order to identify cohorts that can potentially benefit more from the use of preventive interventions.

The history of the discovery of renin in 1896 by Robert Tigerstedt and Per Bergman, the life and creative path of these scientists are described. In animal experiments, they demonstrated that injection of the renal extract to the animals results in a significant increase in blood pressure. Later, they defined the location of renin synthesis (the renal cortex), its physical and chemical characteristics (peptide), analyzed vasoconstriction effect and pharmacokinetics (velocity and duration of the effect).