In developed countries hypertension is observed in 6 - 15% of all pregnancies and occupies the second place in pregnancy morality rate after embolism. Hypertension can be dangerous not only for maternal but fetal deal h as well. Criteria for pregnancy hypertension are the same as general criteria ( ≥ 140 / ≥ 90 mm Hg). Hypertension in pregnancy is classified as following; preexisting hypertension, gestational hypertension, preeclampsia, mixed hypertension (preexisting and gestational). All antihypertensive drugs excluding methyldopa are contraindicated during the first and second trimesters, while several other drugs can be administrated during the third trimester.

Preeclampsia-eclampsia is still one oi the leading causes of maternal and fetal morbidity and mortality. Despite active research for many years, the etiology of this disorder exclusive to human pregnancy is enigma. Recent evidence suggests there may be several underlying causes or predispositions leading to the signs of hypertension, proteinuria and edema, findings that allow us to make ithe diagnosis of the «syndrome» of preeclampsia. Despite improved prenatal care, severe preeclampsia and eclampsia still occur. Although understanding of the pal pathophysiology of there disordes has improved, treatment has not changed significantly in over 30 years. Although postponement of delivery in selected women with severe preeclampsia improves fetal outcome to a degree, this is not done without risk to the mot her. The search for the underlying cause of this disorder and for a clinical marker to predict those women who will develop preeclampsia-eclampsia is ongoing, with its prevention the ultimate goal. Moreover, prospective longitudinal studies are needed to better assess the role of circulating angiogenic factors for the identification women at high risk of preeclampsia and the early diagnosis of disease.

All at the clinical manifestations ol preeclampsia could be attributed to the endothelial cell dysfunction leading to end-organ damage and hypoperfusion. Preeclampsia is a result immune maladaptation. The candidates mediators of immune maladaptation in preeclampsia include cytokines (especially tumor necrosis factor, (TNF-a) and interleukin-2 and IL-6). In addition a lower level of messenger RNA for HLA-G has been described in the trophoblast cells of preeclamptic patients. Increased syncitiotrophoblast shedding as a consequence of placental apoptosis may contribute to endothelial dysfunction. The aim of this review is to summarize the current understanding of the pathogenesis of preeclampsia with special emphasis on recent discoveries which support the notion that immune maladaptation plays an important role in the pathogenesis of preeclampsia.

Study EPIGRAPH-2 focuses on evaluating clinical efficacy and safety of a combination treatment for AH including the use of non-fixed combinations of enalapril and indapamid. It was shown that early initiation of treatment with the non-fixed combination of enalapril and indapamid (Enzix) in patients with I-II degree AH as compared to routine therapy results in a fast reduction of BP, significant decreases in numbers of patients with LV hypertrophy (LVH) and proteinuria, improvement of quality of life in patients with AH, decrease in the frequency of hospitalizations and additional visits to doctor's office. Furthermore this therapy is cost effective.

76 elderly patients with cardiac heart disease (CHD) (31 male and 45 female) were included in the study. Mean age was 81.6 ± 3.4 (from 76 to 89) years. All investigated patients had stable angina pectoris (I-III class). The duration of disease was 8-15 years. The patients were hypertensive (mean arterial pressure 164.5 ± 5.8 / 100 ± 4.3 mm Hg) and had clinical symptoms of heart failure (II class by NYHA). The mental status was evaluated by variety specific tests. The quality of life was assessed by using questionnaire scale SF-36 Health Stains Survey. All subjects were treated by nitrates. ACE-inhibitors and diuretics. Patienis were divided into 2 groups, clinical data and demographies signs of witch, were comparable. 29 patients (1 group) received Metocard 25-100 mg per day. 27 patients were included in control group. Patients of 1 group demonstrated more pronounced increase of distance in test with 6-minutes walking. The depression level after treatment period was significantly reduced in patients of 1 group compare with control group and it's precede level (Camilton scale). Evaluation of quality of life following treatment period shewed statistically significant improvement of number indexes of scale SF-36 Health Status Survey.

The aim of the study was to compare i he clinical efficacy and tolerance of fixed combinations of angiotensin-converting enzyme (ACE) and diuretic noliprel and co-renitec in patients with mild and moderate arterial hypertension with high risk of cardiovascular events. All investigated patients didn't achieved normal AP level with monotherapy. The study was blinded, randomised and performed in parallel groups (20 subjects in each group). The clinical effects were evaluated after 6 months of therapy by 1 tablet of noliprel-forte (4 mg / 12.5 mg) or co-renitec (20 mg / 12.5 mg). The antihypertensive effect was comparable for both dings, but fixed combination of noliprel-forte show advantage in reducing of LV hypertrophy and improvement of arterial elasticity.

The aim of this work is studying of double-phase rhythm characteristics of pulse pressure (PP) at untreated patients AH. The absent of night reduce of PP can be the consequent of night incommensurable change of systolic and diastolic pressure at night in comparison with day change. It was revealed two types of incommensurable double-phase rhythm of pulse pressure ( PP) on the basis of database analysis: Type 1 - with night increase of SHP (type 1a with night decrease DBP, type 1b with gap of increase DBP from SBP at night). Type 2 - with decrease of SBP and DBP at night. Ratio of daily index SBP and DBP ≥ 0,70 provide for decrease PP at night in comparison of day hours with probability ≥ 96 %. Accepting k = 0,70 as bench mark allow us to insert quantitative characteristics of double-phase rhythm of pulse pressure (PP), without using the traditional measure scale of daily index, the usage opportunity of which by BP demands more precise definition The presence of incommensurable daily rhythm of BP was associated with more expressed abnormalities from the point of target organs even with normal daily rhythm of SHP. Thus, I he estimation of proportionality of daily rhythm of SHP and DBP against their daily index is very important additional characteristic of daily profile of HP, allowing to identify patients in dipper and non-dipper groups, whose target organs condition can't be explained by the character of double-phase rhythm of SHP.

Although preeclampsia (PE) is a major cause of maternal and fetal mortality, its pathogenesis is not fully understood. Endogenous digitalis-like sodium pump ligands (SPLs) are believed to be involved in pathophysiology of PE, as illustrated by clinical observations that DIGIBIND, a digoxin antibody which binds SPLs. Lowers blood pressure (BP) in PE. Recently we reported that plasma levels of marinobufagenin (MBG), a vasoconstrictor SPL, are increased four-fold in patients with severe PE. In the present study, we tested whether polyclonal antibodies to MBG and ouabain, and DIGIBIND can reverse inhibition of erythrocyte Na/K-ATPase (NKN) from patients with mild PE. Development of PE was associated with two-told rise in plasma MBG levels (1.58 ± 0.15 vs. 0.80 ± 0.11 nmol/E: P < 0.01). The activity of erythrocyte NKA in 12 patients with PE (BP, 149 ± 3 / 93 ± 3 mm Hg; 28 ± 2years; gestational age, 37 ± 1 weeks) was lower, than in 6 normotensive gestational age-matched subjects (1.56 ± 0.18 vs. 3.11 ± 0.16 umol Pi/ml/hr; P < 001). In vitro treatment of erythrocytes from PE patients with anti-MBG antibody hilly restored the NKA activity (3.26 ± 0.41 umol Pi/ml/hr; P < 0.01), the effects of DIGIBIND was marginally significant (2.53 ± 0.32 pmol Pi/ml/hr), while anti-ouabain antibody was not effective (2.25 ± 0.25 umol Pi/ml/hr, P > 0.5) were less effective. Our present observations provide evidence for a role of MBG in pathogenesis of PE, and suggest that antibodies against MBG may be used to treat the syndrome.

Modern concepts about role of autonomic nervous system central regulation disturbance in pathogenesis of arterial hypertension are analysed in this article. Also it is examined presented hypothesis. explaining the increase of sympathetic nervous system activity and depression of vagal nerve tonuson experimental pathology at animals and essential hypertension at human.

The aim of the study was lo evaluate tolerance of rilmenidine and its combination with amlodipine in ALTAIR study population. The study included 677 patients. 610 (90.4 %) completes it successfully. 126 adverse events have been observed, but only in 4.4 % cases it lead to therapy discontinuation. Adverse events were most frequent on i week visit, later due to excluding of some patients and disappearance of several adverse events its rate. The most frequent adverse effect was dry mouth which was registered in 64 (9.5 %) patients. In conclusion, analysis of ALTAIR data indicates that rilmenidine is well tolerated taking alone оr in combination with amlodipine in patients with mold-to-moderate hypertension. Moreover, rilmenidine therapy is accompanied by improvement of quality of life.