The term «metabolic syndrome» refers to a clustering of specific cardiovascular disease (CVD) risk factors whose underlying pathophysiology is thought to be related to insulin resistance. Since the term is widely used in research and clinical practice, we undertook an extensive review of the literature in relation to the syndrome’s definition, underlying pathogenesis, and association with CVD and to the goals and impact of treatment. While there is no question that certain CVD risk factors are prone to cluster, we found that the metabolic syndrome has been imprecisely defined, there is a lack of certainty regarding its pathogenesis, and there is considerable doubt regarding its value as a CVD risk marker. Our analysis indicates that too much critically important information is missing to warrant its designation as a «syndrome.» Until much needed research is completed, clinicians should evaluate and treat all CVD risk factors without regard to whether a patient meets the criteria for diagnosis of the «metabolic syndrome.»

The aim of the study was to assess metabolic abnormalities in women with different patterns of hypertension during pregnancy in a prospective long-term observational study. 38 females were followed for 10 years after pregnancy. 16 females with normal pregnancy served as a control group. It is shown than hypertension during pregnancy predispose to blood pressure stabilization, target organ damage as well as metabolic disturbances and can predispose to metabolic syndrome manifestation. Maternal weight before pregnancy, and weight increase during pregnancy are predictors of future metabolic syndrome. It was shown also that enalapril 5-20 mg per day can significantly reduce blood pressure and improve metabolic glucose and lipid parameters in such women.

The review describes modern view in metabolic syndrome, diagnostic criteria and management. ACE inhibitors are shown to be indicated to such patients. Trandolapril due to its significant advantages - long duration of action, dual elimination and high tissue activity can be considered predominantly indicated to patients with metabolic syndrome.

The article deals with the overview of different classes of antihypertensive centrally acting drugs. Author’s own experience concerning the use of moxonidine in postmenopausal hypertensive obese women is also provided.

All known components of metabolic syndrome are related to sympathetic hyperactivity. Sympathetic overactivity participates in genesis oa obesity-related hypertension. The mechanisms include leptin, insulin, free fatty acids as well as obstructive sleep apnea syndrome. Drugs inhibiting sympathetic drive are indicated to such patients.

The review describes result of pharmacoecomic analysis of treatment of hypertension and heart failure with ACE inhibitors. It is shown that cost-effectiveness analysis can reveal economic advantages of several drugs that seem to be more expensive compared to other representatives of the same drug class.

The aim of the study was to evaluate effects of rilmenidine and its combination with amlodipine on plasma glucose and lipids as well as body weight in ALTAIR study population. Rilmenidine therapy resulted in several positive metabolic effects: decrease in glucose, total cholesterol and triglyceride levels as well as decrease in body weight. The most prominent metabolic effects were shown fro patients with concomitant obesity and in diabetic subpopulation. In conclusion, analysis of ALTAIR data indicates that Imidazoline agonists, in particular rilmenidine, can be considered the first drug choice in patients with metabolic abnormalities.

48 patients with exercise-simulated ventricular arrhythmia of high gradation (IV-V degree in classification of Lown, Wolf) were investigated (ECG monitor, Bicycle ergometry, test with nitroglycerin, echocardiography). Observed results proved the contribution of increased symphathetical tone m arrhytmogenesis. Selective long-acting beta-blocker betaxolol was admitted as a pathogenic therapy of such conditions. The control studies demonstrated high antiarrythmic efficacy of betaxolol in the treatment of ischemic ventricular rhytm disturbances in patients with Coronary Artery Disease as well as m hypersymphaticotonia-related non-coronary ventricular arrhythmia.

We inspected 179 children and adolescents aged 9-17 years with primary arterial hypertension (AH) and 158 schoolchildren aged 7-17 years. All the hypertensive children underwent 24 hour ABPM. Family history of all the children was studied in particular of cardiovascular diseases. The 19-83G/A polymorphism of renin gene (REN), the M235T polymorphism of the angiotensinogen gene (AGT), the I/D polymorphism of angiotensin converting gene (ACE), the Al 166C polymorphism of angiotensin II type 1 receptor (AGTR1) gene, the C3123A polymorphism of angiotensin II type 2 receptor gene (AGTR2), I/D and T/С polymorphisms of the bradykinin receptor 2 gene (BKR2), were analyzed. We found out the significant increase of A allele and genotype AA of 19-83G/A polymorphism of gene REN frequencies of the children with stable AH in comparison with control group. In the group of children with stable hypertension - in comparison with the group of children, who has white coat hypertension and labile AH, we found out statistically significant prevalence of T allele the M235T polymorphism of the gene AGT. Distribution of I/D polymorphisms frequencies for ACE and BKR genes was similar in children and adolescents with primary AH compared to control group. The children with AH, who had relatives with coronary disease, had significant increase of A allele and genotype AA polymorphism A1166C of gene AGTR1 frequencies. We did not find out significant differences in distribution of A and С alleles of C3123A polymorphism of gene AGTR2 between the hypertensive children and control group. The males with AH had significant distribution difference of alleles polymorphism T58C gene BKR2 with allele С increase.

The aim of present study was to investigate the prevalence of cardiovascular disease (CVD) in out-patient cohort of patients with diabetic foot ulcers (DF). 356 patients with foot ulcers were studied. Mean age 56,9± 11,9 yrs., duration of DM 18,7±9,4 yrs., BMI 26,4±4,9 kg/m². Type 2 DM: 63,4%. Mean HbAcl: 9,56 ± 1,59%. Prevalence of myocardial infarction and stroke were studied according to medical records and EC G data. Hypertension was diagnosed at the visit. Prevalence of CVD was 79,2%. Hypertension was the most prominent pathology (74;7%). Mean levels for systolic BP was 155,8±29,2 mm Hg, and for diastolic one - 87,3±12,2 mm Hg. Diabetic nephropathy was diagnosed in 87,8% hypertensive patients. Ischemic heart disease was diagnosed in 26,5% patients. Prevalence of myocardial infarction and stroke was 9,5% and 8,5% respectively. Whereas patients with CVD were characterized with old age and overweight, the duration of diabetes mellitus and HbAlc level did not differ from patients without CVD. We conclude that hypertension is the most frequent pathology observed in patients with DF. The diabetic nephropathy contributes significantly to this hypertension. CVD are associated with old age but not with duration of DM and HbAlc level.

The article reveals the results of original study about effects of therapy of metoprolol (“Metocard”, Polfarma) in 32 patients with stable angina pectoris II-III and arterial hypertension I-II. Average maximal effective and well-tolerated dose of Metocard was 93,0±5,62 mg per day. The 24-hour monitoring of blood pressure and ECG, as well as treadmill test, biochemical analyses, Echo-CG, MMPI, and the Midlsec tests were performed before and six weeks after the treatment onset. It’s effective antiischemic, hypotensive and antiarrhythmic actions were revealed. Metocard demonstrated positive influence on cognitive functions and psychoemotional status of patients; there were no any negative influences on lipid metabolism and diastolic function of left ventricle.