According to modern ideas, hypertension is the leading component of the metabolic syndrome (MS) in the Russian Federation. The interaction of genetic and environmental factors is known to create a cascade of cardiometabolic disorders that reduce the patients’ quality of life, increase the risk of cardiovascular complications, morbidity and all-cause mortality. There is a complex of unfavourable factors acting in MS. An active search for other medical risk factors in a hypertensive patient, including subclinical organ damage, followed by adequate treatment of each of the components, should be encouraged.

The article discusses ventricular-vascular interaction that is a key factor of cardiovascular functioning and heart energy proile in healthy individuals, in aging, and in different pathological states.

Angiotensin receptor blockers represent a relevant group of cardiovascular drugs. The results of clinical trials of a generic Valsartan (Valsakor) are reviewed in the paper. Valsartan combines high antihypertensive and organoprotective effects with the low risk of signiicant drug interactions. Due to the favorable metabolic proile valsartan is the drug of choice in hypertension, metabolic syndrome and type 2 diabetes mellitus, and the long-term therapy is associated with the reduction of the risk of new-onset diabetes. Valsartan is effective in primary and secondary prevention of atrial ibrillation, congestive heart failure and chronic renal failure.

The recent interest to plasma renin activity (PRA) is due to the opportunity of antihypertensive therapy choice that is based on the understanding of the interrelation between renin-angiotensin-aldosterone system (RAAS) and mechanisms of water balance mediated by the renal sodium absorption and water retention. PRA is the way to understand the primary mechanism of blood pressure elevation. PRA < 0,65 ng/ml/h indicates the water retention, and hypertension is considered low-renin and «volume-dependent». If PRA is more than 0,65 ng/ml/h hypertension results from excessive renin secretion and RAAS activation.

Objective. The activity of renin-angiotensin-aldosterone system (RAAS) is increased in patients with ab-dominal obesity (AO). However, till present time it is unclear whether RAAS activation or hypertension (HTN) found in 50 % patients is the primary disorder.

Design and methods. We have studied plasma renin activity (PRA), plasma aldosterone concentration (PAC), their ratio PAC/PRA in patients with AO and related HTN and in subjects without AO.

Results. PRA was higher in patients with AO versus people without obesity (2,5 ± 0,2 and 1,7 ± 0,7 ng/ml/hr, p = 0,013), there was a tendency to the reduction of the ratio PAC/PRA in obese patients (14,6 ± 0,9 and 19,7 ± 3,3, p = 0,08). In the subgroup of patients with AO and HTN the PRA was higher, and the ratio PAC/PRA was lower than in obese patients without HTN (PRA: 3,3 ± 0,4 and 1,7±0,2 ng/ml/hr, p = 0,005; PAC/PRA: 11,4 ± 1,1 and 17,4 ± 1,4, p < 0,0001). PRA and systolic blood pressure positively correlated. In patients with morbid obesity (3 degree according to the WHO classiication) obesity may play a signiicant role in the increase of RAAS activity, especially in the absence of concomitant HTN. The ratio PAC/PRA in over weight patients with AO was higher than in patients with AO and body mass index ? 30,0 kg/m (17,2 ± 1,7 and 12,5 ± 1,0 kg/m, p = 0,04). PRA was higher only in patients with AO and co-existing hypertension (3,4 ± 0,7 and 1,1 ± 0,2 ng/ml/hr, p = 0,04).

Conclusions. RAAS activity is increased in patients with AO, also due to the co-existing HTN. However, in the absence of elevated blood pressure obesity per se may play a signiicant role in RAAS hyperactivity.

Objective. To study personal characteristics affecting health behavior in individuals with different risk of metabolic syndrome (MS).

Design and methods. We examined 138 respondents (aged 20–62 years) with the use of the medical examination, interview, observation and personality questionnaires (coping style, locus of control, alexithymia), and personality and behavioral characteristics of patients with different risk of MS were identiied.

 Results. Subjects with MS and single components of MS are characterized by emotional eating behavior, lack of sleep, lack of exercise, alexithymia, more external locus of control, avoidant coping strategies. The study showed a signiicant role of internal attitudes in the formation of health-promoting eating behavior, and the correlation between coping style and characteristics of eating behavior and smoking.

 Conclusion. The data support the importance of corrective measures aimed at changing not only the lifestyle, but also personal attitudes, and behavioral patterns that have an impact on health.

Objective. To study personal characteristics affecting health behavior in individuals with different risk of metabolic syndrome (MS).

Design and methods. We examined 138 respondents (aged 20–62 years) with the use of the medical examination, interview, observation and personality questionnaires (coping style, locus of control, alexithymia), and personality and behavioral characteristics of patients with different risk of MS were identiied.

 Results. Subjects with MS and single components of MS are characterized by emotional eating behavior, lack of sleep, lack of exercise, alexithymia, more external locus of control, avoidant coping strategies. The study showed a signiicant role of internal attitudes in the formation of health-promoting eating behavior, and the correlation between coping style and characteristics of eating behavior and smoking.

 Conclusion. The data support the importance of corrective measures aimed at changing not only the lifestyle, but also personal attitudes, and behavioral patterns that have an impact on health.

Objective. To study interconnection between hyperleptinemia, the quality of life (QOL) and the severity of metabolic disorders in patients with essential hypertension with metabolic syndrome (MS).

 Design and methods.We have examined 46 patients with essential hypertension (blood pressure < 180/110 mm Hg), accompanied by MS. Along with complete clinical, laboratory and instrumental examination, customary in a specialized cardiologic clinic, the QOL research was carried out using MOS SF-36questionnaire. Besides, the concentration of leptin in blood serum was determined.

Results and conclusions. Patients with essential hypertension with hyperleptinemia show higher intensity of clinical and laboratory markers of MS, higher activity of the systemic inlammatory response and increased QOL. A statistically signiicant inverse correlation between serum leptin level and QOL scales (SF-36) was detected.

Background. High blood concentration of D-dimer is a reliable marker of activation of intravascular coagulation, but does not provide unambiguous information about the functional potential of the ibrinolytic system.

Objective. To determine the contribution of hyperhomocysteinemia (HHcy) in ibrinolysis disturbances in patients with activated intravascular coagulation.

 Design and methods. Plasma samples of 141 patients with activated intravascular coagulation of various etiologies [82 women (58,2 %) and 59 men (41,8 %), mean age 53,2 ± 7,8 years] with the level of D-dimer > 500 ng/ml were studied. The level of total Hcy (tHcy) was determined by high-performance liquid chromatography. In 57 samples ibrinolytic capacity was investigated by turbidimetric global coagulation and ibrinolysis test using as inducers thrombin and tissue plasminogen activator, respectively. 20 samples of donors matched for age and sex served as a comparison group.

 Results. In 52 patients (36,9 % of the total sample) tHcy level was greater than 12 µM, thus a modest HHcy was observed. In 29 patients (50,9 % of the patients tested for ibrinolysis capacity) the activation of intravascular coagulation was combined with hypoibrinolysis, and the frequency of HHcy in this group reached 58,6 %. A strong correlation between the time of ibrinolysis and tHcy concentration was found (Rs = 0,564, p = 0,0001).

Conclusion. Thus, it appears that moderate HHcy is not only one of the risk factors for the activation of intravascular coagulation, but also causes inhibition of ibrinolysis in this pathology.

Objective. To perform a clinical and economic analysis in order to assess the beneits of antihypertensive and renal protective effects of the ixed combination perindopril arginine and indapamide in versus «traditional therapy» in hypertensive patients with renal insuficiency.

Design and methods. We evaluated an indicator «costs-eficiency» by the cost of increase of glomerular iltration by 1 ml/hour (by Cockcroft-Gault formula, in each of group and decrease by 1 mg/l of proteinuria in both groups.

stenoses of precerebral arteries, to determine predictors of the complications of verticalization in order to perform a more differentiated approach to the implementation of the protocol to ensure the safety of the process.

 Design and methods. The study included 50 patients with hemispheric ischemic stroke. Group 1 (n = 30) included patients without hemodynamically signiicant stenoses of the brachiocephalic arteries (BCA), group 2 (n = 20) included patients with hemodynamically signiicant stenoses of the BCA. Verticalization was carried out on a tilt-table «Vario-Line» («Beka») on the 1, 2, 3, 4, 5 and 14 day from the onset of the disease.

 Results. In group 2 an earlier decline in the rate of cerebral blood low (CBF), as well as the re-reduction rate of the CBF during the session of verticalization were detected. During the interruption between the sessions, indicators of autoregulation recovered more slowly in patients from group 2. Moreover, the cerebral autoregulation indicators were decreased during the course of verticalization, by 14 day only a quarter of these patients had a ratio of 10 % overshoot.

Conclusions. Patients with hemodynamically signiicant stenoses of symptomatic BCA need to use a special regimen of verticalization that would appear «gentle» in order to prevent the complications of verticalization. Assessment of cerebral blood low autoregulation by the overshoot factor can help to identify patients with the increased risk of complications.