Background. Imidazoline receptor agonist moxonidine besides its antihypertensive effect, can increase insulin sensitivity, reduce leptin level, improve lipid metabolism. However, the efficacy, tolerability and pleiotropic effects of moxonidine in postmenopausal women with essential hypertension (EH) and metabolic syndrome (MS) are not well established, and it was the objective of this study. Design and methods. 30 postmenopausal women with EH and MS (52,5 ± 0,4 years old) were included. Moxonidine was administered (400-600 mkg/day) for 12 weeks. Waist circumference (WC), hip circumference (HC), WC/HC ratio, body mass index (BMI), insulin, leptin level, glucose, lipid profile of blood serum, index of insulin resistance (HOMA-IR) and index of functional activity of pancreatic beta cells (HOMA-FB), echocardiography, intima-media thickness (IMT) of common carotid arteries (CCA). Results. Moxonidine therapy was associated with blood pressure (BP) decrease, body weight and BMI decrease, high-density lipoprotein (HDL) cholesterol and HOMA-FB index increase. Left atrium diameter and volume decreased, left ventricular diastolic function improved. Conclusions. Moxonidine is an effective antihypertensive drug for the treatment of postmenopausal hypertensive women with MS, which improves a range of metabolic, hemodynamic parameters and leads to the decrease of left atrium volume and diameter.

Objective. To estimate the relationship between circadian blood pressure rhythm disorder and changes in cerebral perfusion and development of cognitive dysfunction in patients with metabolic syndrome (MetS). Material and methods. 52 patients with MetS were involved. All patients were examined by perfusion brain SPECT with^99mTc-HMPAO and comprehensive neuropsychological testing. Results. The results of Brain SPECT showed that cerebral perfusion was significantly decreased in MetS patients in comparison with control group. Relationship between indices of 24-hours blood pressure monitoring, cerebral perfusion and cognitive function was found. Conclusions. Our results suggest that patients with MetS have cognitive disorder, and one of its pathogenetic mechanism is the decrease in brain perfusion related to the circadian blood pressure rhythm disorder.

Objective. To evaluate the influence of personal anxiety on risk of hypertension development in men aged 25-64 years during 20 years. Design and methods: Within the framework of program WHO MONICA-MOPSY a representative sample of men 25-64 years old (1984, 1988, 1994 years) was examined. We used Spielberger's scale for estimation of personal anxiety (PA). The period of follow-up was 20 years (1985-2004). All cases of hypertension developed for the first time were considered to be outcome. Cox-proportional regression model was used for estimation of relative risk (RR). Results. In the group of men with high levels of anxiety (HLA) hypertension was detected in 57,4 %, and mainly in the older age group of 55-64 years - 35,7 %; in the group of 45-54 years old - 27,7 %, in the age of 35- 44 years - 22 %, and in 25-34 years -  14,6 %. During the first 5 years, RR of hypertension was 6,8 times (95 % CI; 2,73-11,368, p < 0,05), for 10 years - 5 times (95 % CI 2,06-9,924, p < 0,01), for 15 years - in 3,8 times (95 % CI, 1,039-7,152, p < 0,05), for 20 years - in 1,4 times (p > 0,05) higher in men with HLA. The highest incidence of hypertension was observed in men with HLA related to divorced and widowed men with incomplete secondary/primary education among the workers in heavy manual and secondary physical labor and retirees. Conclusions. These results indicate that in the male population aged 25-64 years the risk of hypertension is associated with HLA.

Objective. To study the benefits of 24-hour blood pressure monitoring (ABPM) for diagnosing «masked» arterial hypertension (AH) in young men and characteristics of the blood pressure daily profile in this group. Design and methods. 224 men were examined; Among them 100 men were aged 18-30 years, mean age was 23,6 [22,8-24,3] years. Clinical study and instrumental (ABPM) examination were performed. Results and conclusions. It is reasonable to use ABPM as obligatory method to diagnose «masked» AH in young subjects, since in 1/3 cases ABPM data confirm AH when office BP is normal. Main types of alteration of night BP decrease included «over-dipper» (16,0 %) and «non-dipper» (33,0 %) types in young subjects, while «non-dipper» type was predominant (48,4 %) in middle-aged group.

4810 hospitalization cases of patients with stroke were analyzed, 3762 of them had ischemic stroke, and women were predominant. Among patients with ischemic type of stroke the largest number of patients were hospitalized during spring, however, differences by season were not significant. However, the majority of patients were admitted to the hospitals of the Komi republic in January. First place among the risk factors for ischemic stroke takes hypertension, and women are predominant among hypertensive subjects. However, patients with hypertension as well as those with other cardiovascular diseases are significantly older.

Objective. To evaluate the associations between blood pressure (BP) parameters and cognitive functions in adolescents. Design and methods. 549 adolescents of both sexes 14-17 years old were recruited from representative population sample of Novosibirsk. BP levels and cognitive function were determined by standardized screening methods. Letter cancellation test (modified Bourdon's test), Luria's 10-words test and test of excluded of incorrect words were used. Results. Statistically significant associations (p < 0,05) between higher BP, especially diastolic BP, and cognitive dysfunction in adolescents were revealed. Adolescents with higher pulse rate had significantly higher scores of neuropsychological tests. Conclusion. Diastolic BP and pulse rate can predispose to cognitive dysfunction in adolescents.

Objective. Numerous studies demonstrated augmented activity of Na⁺/Li⁺ countertransport (NLC) in erythrocytes of patients with essential hypertension. Molecular origin of ion carrier underlying these abnormalities remains unknown. Because of inhibition of Na⁺-dependent Li⁺ efflux by inorganic phosphate (P_i), it has been proposed that NLC is mediated by an isoform of Na⁺,P_i cotransporter (NPC) expressed in human erythrocytes. Our study examines this hypothesis. Design and methods. NLC activity was measured as Na⁺_o-dependent component of Li⁺ efflux from Li⁺-loaded erythrocytes isolated from human, rat and rabbit. NPC was estimated in the presence of inhibitors of anion exchanger as Na⁺_o-dependent³²P_i influx. Results. NLC activity was below detection limit in rat and ~50-fold higher in rabbit compared to human erythrocytes. In contrast to NLC, NPC in rat, human and rabbit erythrocytes was in proportion of 1:2:6. The loading of erythrocytes with Li⁺ during hr, i.e. a step used for NLC measurement, did not affect the activity of NPC in erythrocytes from any species. Conclusions. The ratio of NLC:NPC activities in rat, human and rabbit erythrocytes is sharply different. These results argue against involvement of NPC isoforms in augmented NLC seen in patients with essential hypertension. They also suggest that comparative transcriptomics of mRNA encoding ion carriers in human, rat and rabbit reticulocytes is a potent tool for identification of molecular origin of NLC.

Objective. The aim of study is asses of the endothelial functional features in patient with bronchial asthma with different types of blood pressure (BP) circadial rhythm.
Design and methods. 62 patients with bronchial asthma (from 25 to 60 years old) were included in our study. Control group was represented by 30 healthy people for examination of endothelial function and 77 patients with essential arterial hypertension for 24-h blood pressure rhythm analysis. We described 2 groups of patients («dippers» and «non-dippers») by ambulatory 24-h blood pressure monitoring.
Results. «Non-dipper» type was significantly prevalent in patient with asthma in comparative with patients with essential arterial hypertension (51,6% opposite 33,7%). The flow-depended endothelial dysfunction is most common in patient with asthma (dippers and non-dippers) than in control group. Negative correlation between nitroglycerin-depended vasodilatation and night-depressing systolic and diastolic blood pressure degree was presented in the study.
Conclusion. We founded associations between endothelial dysfunction and BP circadial rhythm in patients with bronchial asthma, especially in «non-dippers».

Objective. To study relation between carotid atherosclerosis and arterial hypertension, and possible benefits of surgery. Design and methods. 70 hypertensive patients operated on cerebral arteries were examined: 50 patients had stenosis of carotid arteries (CA) and 20 - cerebral arterial anomalies. Results. The patients with carotid atherosclerosis had higher blood pressure (BP) than patients with brachiocefalic arterial anomaly (103,6 ± 11,3 and 91,7 ± 6,6 mmHg, respectively; r = 0,00007). This difference has disappeared in postoperative period. Both systolic (from 145,1 ± 14,7 to 135,6 ± 12,3 mmHg; р = 0,02), and diastolic (from 83,3 ± 10,2 to 78,1 ± 9,7 mmHg; р = 0,02) blood pressure reduced after the surgery on CA. Conclusions. We conclude that there is an association between ВР level and carotid atherosclerosis. The reduction of BP was observed in postoperative period in patients with atherosclerosis of CA.

Objective. To evaluate the antihypertensive and organoprotective effects of the calcium antagonist - slow release Nifedipine (Cordaflex RD) and diuretic Indapamid MR in patients with isolated systolic hypertension (ISH). Design and methods. 46 patients with ISH (66,2 ± 4,8 years) were included. Patients were divided into 2 clinical groups: 1st group (n = 26) took cordaflex RD, and 2nd group (n = 20) was given the Indapamide MR. The cardio- and angioprotective effects of the medications was evaluated. Results and conclusions. Cordaflex leads to the decrease of both systolic and diastolic blood pressure (SBP and DBP), whereas Indapamide influences SBP more, than DBP. Based on echocardiography results, both medications decreased the heart wall thickness, improved systolic and diastolic left ventricular function. Cordaflex RD significantly improved the diastolic left ventricular function. Both Cordaflex RD and Indapamide favorably influenced peripheral arteries endothelial function in elderly subjects with ISH. Both medications effectively reduced the index of the true stiffness CAVI.

Objective. To assess the antihypertensive efficacy of monotherapy with Nifedipine Retard, Enalapril and Metoprolol in view of polymorphism of genes associated with lipid metabolism, renin-angiotensin system, β-adrenoreceptor and apoptosis cascade in patients with essential hypertension. Design and methods. 150 Tatar hypertensive patients were included, and blood pressure monitoring and gene polymorphism determination were performed. Antihypertensive therapy was prescribed for one month. Results. There are associations between antihypertensive efficacy and the number of genetic markers in hypertensive patients. We suppose that protein products encoded by GluR2, HIF-1А, CASP9, Ephrin-B3 genes play a role either in blood pressure regulation or in the mechanism of blood pressure decrease under therapy with Nifedipine Retard, Enalapril or Metoprolol. Conclusion. GluR2, HIF-1А, CASP9, Ephrin-B3 genes polymorphisms can be used to predict the efficacy of treatment with Nifedipine Retard, Enalapril and Metoprolol in hypertensive patients.

Objective. To evaluate the side effects (SE) of angiotensin-converting enzyme inhibitors (ACEI) in hypertensive patients in real practice in Russia in a study based on pharmacoepidemiologic design. Design and methods. Under 337 reports of SE there were 162 on ACEI. Mean value of SE for 1 patient was 2,83; mean value of class-specific SE - 1,17. The disorders of respiratory tract (68 % patients), central nervous system (51,2 %) and skin (21 %) were predominant; the most frequent SE were cough, hemodynamic SE (headache, dizziness, weakness), skin allergic SE. There was gender difference in frequency of cough, but no difference was found in the structure of SE among young and elderly patients. The most serious SE were observed in obese patients (body mass index > 30 m²). 6,2 % patients needed hospitalization. More than 80 % drugs were ACEI generics that characterizes their safety.

Objective. To characterize diabetic nephropathy and cognitive function in patients with arterial hypertension (AH) and diabetes mellitus (DM) type 1, complicated by orthostatic hypotension (OH), and to assess the benefits of venoprotector therapy for the correction of dyscirculatory encephalopathy (DE) and diabetic nephropathy (DN). Design and methods. Sixty patients with AH, DM type 1 and OH were included in the study. Schellongs' orthostatic probe, microalbuminuria (MAU) screening with «Micral-Test-11», Mini Mental State examination (MMSE) test, 10 words memo probe, Spielberg test, Beck questionnaire were used. Antihypertensive therapy included «Enalapril» («Hemofarm», Serbia), venoprotective therapy - with «Detralex» («Servier», France). Results. Adequate antihypertensive therapy in patients with DM type 1 in combination with AH and OH leads to aggravation of postural hypertension symptoms. Blood pressure decrease in orthostatic probe and cognitive disorders are associated (r = 0,56, p = 0,009). Use of active orthostatic probe (AOP) leads to the increase of MAU. Venotonic therapy attenuates the symptoms of postural hypotension, leads to the decrease of MAU in AOP and improves cognitive function.