The paper presents a meta-analysis of open antihypertensive effectiveness trials of Indapamide SR (Arifon Retard, Servier Laboratories, France) in hypertensives. 24 Russian (n = 4952) and 4 foreign (n = 4634) trials were included in analysis. Russian trials show that Indapamide retard both as a monotherapy and a component of the combination therapy leads to a 17,8/14,0 % decrease of systolic/diastolic blood pressure that is a reduction for 29,2 (95 % ДИ 28,9-29,5)/12,3 (12,1-12,5) mmHg in patients with uncontrolled hypertension. Baseline blood pressure was the main predictor of its reduction, and the most significant reduction for 32,6 (95 % ДИ 25,5-39,6) was seen when the average baseline systolic blood pressure exceeded 170 mmHg. Antihypertensive efficacy of Indapamide retard was similar in Russian and foreign trials. However, incidence of therapy-related side effects was higher (5,9 %) in Russian trials than in foreign ones (3,3 %, p < 0,001). Therefore, meta-analysis based on the data of open Russian trials confirms the antihypertensive effectiveness of Indapamide retard and demonstrates the comparability of the results to those found in multicenter foreign studies.

The paper reviews publications concerned the role of nonesterifi ed fatty acids (NEFA) in pathogenesis of cardiovascular
diseases. NEFAs are four and more carbons chain length carbonic acids and they are presented in free form (nonesterifi ed)
in human body. Plasma NEFAs are produced by the adipose tissue triglyceride lipolysis, another source are lipoproteins
such as chylomicrons, very low density lipoproteins and intermediate density lipoproteins. Elevated NEFA concentrations
in plasma are the risk factor of cardiovascular diseases and type 2 diabetes mellitus and the independent risk factor of
hypertension and sudden death. NEFA plasma concentration is elevated in atherosclerosis, acute myocardial infarction,
diabetes mellitus, obesity, hypertension, and often in metabolic syndrome. A probable cause of NEFAs accumulation in
plasma may be overeating and low physical activity, which result in increase of adipose tissue mass, lipolysis intensifi cation
and elevation of NEFAs concentration in plasma. The role of elevated plasma NEFA concentration in a number of conditions
(abdominal obesity, atherogenic dyslipidemia, insulin resistance, type 2 diabetes mellitus, endothelial dysfunction, vascular
infl ammation, atherosclerosis, hypertension, ischemic heart disease, rhythm disturbances, sudden death) and possible ways
of their correction are discussed.

Objective. To assess effi ciency of in hypertensive men capable of working. Design. Clinical study and instrumental
(Ageing Male Score, AMS) examination were performed in 15 hypertensive men aged 32,8 ± 6,9 years old. Results and
conclusions. Target blood pressure was achieved in 14 hypertensive men treated with eprosartan 600 mg/hydrochlorthiazide
12,5 mg during six month. Moreover, this therapy was associated with a signifi cant increase of normotonic reaction rate
at physical load during veloergometry, and a signifi cant reduction in symptoms of androgen defi cit assessed by AMS in
men.

Objective. To study the infl uence of enalapril 20 mg/day on the sympathoadrenal (SAS) and renin-angiotensinaldosterone
systems (RAAS). Design and methods. 149 subjects (102 patients with essential arterial hypertension (EAH)
and 47 patients with primary hyperaldosteronism, PHA) were included. Mean systolic blood pressure (BP) (M m) was
194,6 7,4 mmHg, diastolic BP - 116, 2 5,4 mmHg. Plasma renin activity (PRA) and plasma aldosterone concentration
(PAC) were estimated by radio-immune method in active patients. PRA was rated as normal if ranged 1,0-3,0 ng/ml/h,
PAC - 0,18-0,83 nmol/l (5-23 ng/dl or 50-230 pg/ml). Normal PAC/PRA ratio was 5-23. The daily urine excretion of
adrenaline (normal - 18-33 mmol/l) and noradrenaline (normal - 150-256 mmol/l) were determined by fl uorometric
method. Conclusions. 1) Effects of angiotensin-converting enzyme (ACE) inhibitors on the synthesis of aldosterone and
catecholamines in EAH patients are associated with the changes of circulating angiotensin II concentration, and in PHA
patients - with the decrease of tissue angiotensin II concentration in cortical layers of the adrenal gland and central nervous
system. 2) Reactive increase PRA in EAH patients treated with enalapril is rather related to the blockade of renal tissue
angiotensin-converting enzyme than to the circulating angiotensin II. 3) PHA patients are characterized by the phenomenon
of up regulation of aldosterone receptors and of tissue renin-angiotensin system that is defi ned by optimum reduction of
PAC, the lack of normalization of PRA and blood pressure in response to the application of enalapril 20 mg/day.

Atrial fi brillation is the most common heart rhythm disturbance. Hypertension is a well-established risk factor for many
cases of atrial fi brillation, but its predictors are still unknown. The available treatment approaches for atrial fi brillation
management are characterized by limited effectiveness and high risk of side effects, thus encouraging researches for new
studies. Better understanding of the mechanisms leads to the development of new therapy approaches. This paper presents
the results of the study of atrial fi brillation prevention in hypertensive patients getting direct renin inhibitor.

Background. A large amount of experimental and clinical data on the content and the role of chemical elements in the
human body is accumulated by nowadays. However, the state of mineral metabolism, mechanisms of action and the role
of chemical elements in the etiology and pathogenesis of infl ammatory, autoimmune and other diseases are to be studied.
Objective. To examine the state of mineral metabolism (calcium - Ca, magnesium - Mg, iron - Fe, cobalt - Co,
copper - Cu, zinc - Zn) in various pathogenetic variants of infl ammatory processes in the blood serum of patients with
acute coronary syndrome, community-acquired pneumonia and rheumatoid arthritis.

Background. Systemic and local amyloidosis can be evident in the oral cavity. Biopsy including oral mucosa biopsy
is a standard of amyloidosis diagnosis. Oral mucosa species of the cheek, gingiva, tongue and lip were admitted for the
histological investigation. Material and methods. Cheek and gingival biopsies of 32 patients with I-IV NYHA functional
class of chronic heart failure (CHF) and suspected systemic amyloidosis were investigated histologically with heama
toxylin-eosin and Congo red staining and immunohistochemical analysis to and antibodies (DAKO) and following
investigation in the polar light. Results. Positive reaction was observed in 71,9 % cases, while systemic AL-amyloidosis
(confi rmed by : disbalance) and genetic form of the amyloidosis with predominantly skin disease were diagnosed only
in 3 cases (9,4 %). Dental investigation of the patients with CHF and congo-positive reaction determined high prevalence
of the severe generalised periodontitis (37,5 %). Conclusion. Chronic generalized infl ammation of the periodontium may
be the cause of the local amyloid deposition in the oral cavity.

Objective. To study the opportunities of 24-h blood pressure (BP) monitoring in verifi cation of arterial hypertension
(AH). Design and methods. The retrospective analysis of the 24-hour BP monitoring results of 395 patients was performed.
Sensitivity and specifi city of the hypertensive indices were studied. Results. Ambulatory BP monitoring revealed 90 % of
patients, who had BP over 140/90 mm Hg; however within 100 % sensibility, specifi city of this method was only 17 %.
Based on the average daily BP (over 130/80 mm Hg) AH was verifi ed in 51 %. This index has 100 % sensitivity and 64 %
specifi city. According to the time hypertensive indices (HISx и HIDx ≥ 50 %) that show the same specifi city and sensitivity
AH was established in 28 %, but these values ranging from 30 to 50 % made diffi cult the interpretation of the results The
maximal density of BP, refl ecting the range of systolic and diastolic BP values at 10 mm Hg stepout, demonstrates both
presence and stage of AH with the specifi city and sensitiviy 82 and 87 % respectively. Conclusion. The application of
several highly sensitive and specifi c quantitative indices of 24-h BP monitoring in complex diagnostic approach allows
diagnosing AH.