The paper presents the results of a follow-up and treatment of 30 patients with arterial hypertension (AH) accompanied by the persistent blood pressure elevation that requires continuous antihypertensive therapy and that is associated with type 2 diabetes mellitus. It shows the antihypersensive effect of the imidazoline-receptor agonist moxonidine and its positive action on metabolic parameters and a risk for cardiovascular events in this group of patients.

The review considers the topical problems of the diagnosis and treatment of primary hyperaldosteronism. Studies requited to establish its diagnosis are characterized, Differencial approaches to therapy for aldosterone-producing adenoma and idiopathic hyperaldosteronism, including the specific features of conservative therapy, are detailed.

The antihypertensive effects and tolerance of a fixed low-dose combination of the angiotensin-converting enzyme (ACE) inhibitor perindopril, 2 mg, and the diuretic indapamide, 0.025 mg (noliprel), were studied in patients with mild and moderate arterial hypertension associated with diabetes mellitus. The patients' mean age was 51.36 ± 6.11 years, Hblc was 7.86 ± 1.73 %. The antihypertensive effects were evaluated from the results of daily blood pressure monitoring following 16 weeks of therapy. It was found that noliprel exerted a multidirectional corrective effect on the daily blood pressure (BP): it provided a significant optimal BP lowering during a clay on a long-term basis; significantly normalized the pressure load index in day- and night-time; significantly diminished the baseline increased systolic and diastolic BP variabilities during a day. normalized the impaired two-phase BD profile. The efficiency of treatment was 100 %, as evidenced by clinical BP and diurnal BP profile; the achievement of targeted BP was 88 % by the end of therapy. During therapy with the agent, stable glycemia control preserved and there was no negative effect on the lipid spectrum, which permits the use of the drug in patients with arterial hypertension concurrent with metabolic disorders.

The effects of parenteral enaprilat were evaluated in hypertensive crisis (HC) with cerebral (hypertensive encephalopathy, stroke, transient ischemic attack) or cardiac (acute left ventricular failure, unstable angina) complications. The study covered 190 patients whose mean age was 64.8 years; there were 46 males and 144 females. Cerebral complications due to HC were observed in 119 patients; its cardiac complications were in 71. The decrease in blood pressure (BP) by 15-30 % of the baseline values with achieved diastolic BP less than 110 mm Hg was a criterion for the efficiency of therapy. Changes in clinical symptoms and outcomes were also taken into account. The treatment caused a significant decrease In BP and effective in 64, 80, 74, 72, and 82 % of the patients, respectively. Thus, the study demonstrated that intravenous enaprilat was highly effective in complicated arterial hypertension.

Background. The mechanisms responsible for the antihypertensive effect of selective imidazoline receptor agonists, such as rilmedinine, remain nowadays inadequately explored, improved baroreflectory regulation of the circulatory system in the treatment with antihypertensive drugs makes additional advantages in predicting further progression in patients with hypertensive disease. Aim. To estimate the time course of changes in the vasomotor component of cardiopulmonary baroreflex (CPBR) during acute and chronic therapy with rilmenidine versus atenolol and to study the impact of baroreflectory regulation on the efficiency of further therapy. Results. According to the data of daily monitoring, long-term therapy showed a significant decrease in blood pressure in both groups. Two hours after the use of rilmenidine, the patients showed a heterodirectional changes in the vasomotor component of CPBR whose variability was associated with the efficiency of further 6-month therapy with this drug, which was evaluated by the decrease of the level and variability of the diurnal blood pressure profile, and by the fattens recovery.