Inhibitors of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-Ko-A) reductase (statins) are widely used in treatment hyperlipideamia
and atherosclerosis for more than 30 years. Results of randomized controlled trials studying statins have demonstrated
that for each 1 % reduction of low-density lipoprotein (LDL) one can achieve 0,88 % reduction of cardiovascular
risk. Simvastain (Zocor™) is the fi rst-generation semisynthetic statin registered by FDA in 1988. Over the past 15 years
simvastatin has been widely studied in clinical trials with hard end points (4S, HPS, IDEAL, ACCORD). These trials
showed that treatment with Simvastatin 20-40 mg/day may signifi cantly reduce risk of cardiovascular death by 24-35 %,
coronary death - by 42 %, risk of stroke - by 27 % and total mortality - by 13-30 %. Simvastatin was also well studied
in regression trials (FHRS, MAAS and CIS). Simvastatin - is the best-investigated statin in terms of long-term safety and
tolerability. In particular, in HPS study the incidence of liver damage did not exceeded 0,1 %, myopathy - 0,05 %. Zocor
is well studied in combination therapy with fi brates, niacin and ezetimibe. Fixed drug combination ezetemibe 10 mg/sim
vastatin 20 mg may reduce LDL for more than 50 %, most of high-risk patients can achieve target LDL-C goals. According
to DYSIS study (2009) simvastatin is the most reliable and widely used statin in the world.

Objective. To compare the antihypertensive and cardiovascular protection effects of Indapamide retard in response to
arterial remodeling and heart rate variability (HRV) in hypertensive patients. Design and methods. Structural and functional
indices of heart and brachial artery (BA) by ultrasound examination, circadian blood pressure (BP) rhythm and HRV by 24-hour
ECG and BP monitoring were assessed at baseline and after 6-month therapy with Indapamide retard. Patients were divided
into 2 groups: 1st group included 37 patients without arterial remodeling; 2nd group - 48 patients with arterial remodeling.
Results. Antihypertensive effect of Indapamide retard did not differ in groups. Changes of HRV indices were signifi cantly
higher in 1st group, but the regression of vessel remodeling and increasing of endothelium-dependent vasodilation were
signifi cant in 2nd group. Conclusion. This study shows that cardiac protection and antihypertensive effects of Indapamide
retard realize through autonomic modulation effect in absence of vascular remodeling, but direct vascular effect is observed
in patients with vascular remodeling.

Objective. To study the blood pressure variability, morphofunctional parameters of the heart, kidney and metabolic status
in hypertensive patients with secondary chronic pyelonephritis. Design and methods. The study included 110 patients: 55
patients with arterial hypertension and secondary chronic pyelonephritis, who underwent surgery for upper urinary tract, and
55 patients with essential arterial hypertension. All patients underwent 24-hour blood pressure monitoring, echocardiography;
relative urine density in the morning urine portion, microalbuminuria, blood creatinine were assessed, glomerular fi ltration
rate was calculated using MDRD formula. Results. Patients with arterial hypertension and chronic pyelonephritis have
signifi cant changes of the blood pressure profi le, and hypertrophy and diastolic left ventricle dysfunction are more frequently
observed in this group. A close relation between renal function and the state of the cardiovascular system is established. We
also found higher numbers of total cholesterol, the most atherogenic fractions of cholesterol and triglycerides in this group
compared to patients with essential hypertension.

Objective. To defi ne the endothelial vasoactive substances (nitric oxide, NO; and endothelin-1, ET-1), characterizing
endothelial function in young patients with arterial hypertension (АH) and to identify the diagnostically signifi cant biomarkers
of the endothelial function and their prognostic value for assessment of AH at initial stages in young patients. Design
and methods. 65 male patients with AH (age 20-45 years old), with the level of total cholesterol < 5,0 mmol/l and blood
pressure < 160/100 mmHg; and 32 healthy volunteers (mean age - 32,8 4,9 years) were enrolled. Results. Endotelial
biomarkers (NO and ET-1), characterizing the ratio vasoconstrictor agent (ET-1)/vasodilator (NO) in young patients with
AH can be considered to be a potential prognostic marker of unfavourable course of AH especially at initial stages.

Objective. To investigate plasma levels of nitrates/nitrites (NO2+NO3) and S-nitrosothiols in asthmatic patients,
including patients with concomitant arterial hypertension. Methods. The data were obtained by Greiss method before and after
treatment of asthma exacerbation in asthmatic patients and healthy subjects. Results. This study has shown that evaluation
of NO2+NO3 and S-nitrosothiols should consider asthma severity and the presence of concomitant arterial hypertension.
The level of NO metabolites was higher in mild asthma and in patients with concomitant hypertension of grade 1.

Objective. To assess the incidence of different variants of arterial hypertension (AH) among students daily BP regulation.
Design and methods. 234 students of Stavropol State Medical Academy of both sexes aged 18-23 years (middle age
21,4 0,2 years) were examined, among them 73 men and 161 women. Physical examination and blood pressure (BP)
measuring by traditional and monitor methods were performed. For statistical analysis software package STATISTICA,
version 6,0 was used. Results. 10,7 % (25 people) of students had isolated offi ce AH and 11,5 % (27 people) had latent AH.
Subjects having any type of labile AH demonstrated an increase of daily systolic and diastolic BP and an elevation of mean
hemodynamic and pulse BP that has negative predictive value, they also showed an increase of pathological daily profi le rate.
Conclusions. About a quarter of young people have various forms of AH that can be diagnosed by only use of 24-hour BP
monitoring. They need an active follow-up at the centers of students health.

Objective. To assess the intrarenal blood fl ow in hypertensive patients at orthostatic test. 79 subjects (36 males and 43
females) with arterial hypertension of II stage were enrolled. The renal blood fl ow was investigated using Doppler study
with the spectral analysis at level of interlobar arteries. The direct relation between pulsatility index and pulse pressure was
found (r = 0,52; p = 0,0001). Peripheral resistance and vascular rigidity were higher in patients with increased blood fl ow
acceleration time in interlobar arteries at orthostatic test. Thus, Doppler study of intraparenchymal blood fl ow at orthostatic
test can be used for early diagnosis of structural and functional changes of renal arteries.

Objective. To study the effi cacy of standard therapy supplemented by the complex of vitamins and selenium on the
endothelial function and general carotid artery stiffness in patients with previous myocardial infarction. Design and methods.
Plasma folate, homocysteine and selenium and vascular functional parameters were measured. Results. Administration of
the complex, containing folic acid, pyridoxine, tocopherol, ascorbic acid and selenomethionine leads to improving folate
and selenium status as well as lead to correction of endothelial function and arterial stiffness (p < 0,05). Conclusions. The
results of our study showed that administration of functionally connected vitamins and selenium with the pathogenetic therapy
of coronary heart disease in patients with selenodefi ciency.

Design and methods. Effi cacy and safety of several antihypertensive medications were evaluated in 473 cases of nonthreatening
hypertensive crisis. Blood pressure (BP) was measured by (Korotkov) method, hemodynamic parameters were
evaluated by reographic investigation, and heart rhythm variability was recorded according to the guideline of International
Society of Electrophysiology. Results. It was shown that antihypertensive therapy decreasing sympathoadrenal activity are
preferable in emergency. In this situation clonidine and moxonidine were the most effective. Captopril was active if high
diastolic blood pressure was registered. Nifedipine effi cacy decreased in patients with high sympathoadrenal activity and high
increase of BP. Conclusion. Our results showed that the most effective and safe medication in case of the non-threatening
hypertensive crisis was moxonidine

Objective. To study the dynamics of serum growth hormone (GH), insulin-like growth factor-1 (IGF-1) and markers of
system infl ammation in patients with chronic heart failure (CHF) depending on different phases of heart failure development.
Design and methods. 53 men (age 47-75 years old) with coronary artery disease (CAD), hospitalized because of the CHF
decompensation, were included. The control group consists of 13 men (age 46-69 years old) with ischemic heart disease and
normal left ventricular ejection fraction (LVEF ≥ 60 %). Serum GH, IGF-1, NT pro-BNP and C-reactive protein (CRP) were
measured at baseline, when stabilization was achieved and every 6 month of follow-up. Results. In patients with ischemic
CHF, hospitalized due to the CHF decompensation, signifi cant increase of GH level was found, compared to control group
(1,23 and 0,22 mME/l, p < 0,01). This was accompanied by the decrease in the level of IGF-1 (222 and 415 ng/ml, p < 0,01).
This condition is known as resistance to GH. Improvement of patients' state is followed by the decrease in GH level with
preserved stable low level of IGF-1. The strong interrelation of GH and NT pro-BNP levels remained during follow-up: at
baseline (r = 0,59; p < 0,0001), when stabilization was achieved (r = 0,40; p < 0,0001) and every 6 month of follow-up (r = 0,43;
p < 0,0001). Serum CRP had no difference in patients with CHF compared to controls. However, CRP level signifi cantly
decreased over time: stabilization (p = 0,01) and in 6-month period (p = 0,004). Conclusions. 1) In patients with ischemic
CHF III-IV functional class GH level was associated with IGF-1 level and ranged within normal rates. GH level decreased
when stabilization was achieved, and did not change in 6 months compared to the level of GH at decompensation phase.
2) IGF-1 level in patients with ischemic CHF was decreased compared to patients with CAD and did not change in different
phases of heart failure. 3) CRP level was increased compared to patients with CAD and was decreased at stabilization, as
well as in 6-month period of follow-up. The strong interrelation of GH and CRP levels was shown.

Design and methods. We observed 64 geriatric patients (67,3 3,9 years old) with chronic heart failure (CHF) and
arterial hypertension (AH), which had been divided into 2 groups. The fi rst group included 32 patients who received classical
group educational model, the second - 32 patients who were individually educated based on effective medical consulting.
All patients received standard treatment of AH and CHF (angiotensin-converting enzyme inhibitors, -blockers, diuretics,
aldosterone antagonists and digoxin). Results. Initially less than 14 % of patients had good compliance. After 12 months
of intervention, medication adherence increased to 59,4 % in I group and 87,5 % in II group. In 6 months the dynamics of
clinical symptoms and functional status was positive in all groups, particularly after individual education, the difference
between groups was signifi cant in 12 months. Only in II group we observed signifi cant reduction of emergency calls and
extra hospital admissions due to decompensation of CHF. Conclusion. The complex approach to education of elderly patients
is effective and has economic benefi ts.

Objective. To study the association between N-terminal pro-brain natriuretic peptide (N-proBNP) and diurnal blood
pressure profi le in hypertensive patients. Methods and results. A total of 40 patients were included in the study. Peptide
concentration increased with age, correlated positively with diurnal pulse blood pressure variability and its mean cumulative
value over night period in hypertensive patients. In patients with high plasma concentrations of peptide its level positively
correlates with pulse blood pressure value and its variability and mean cumulative value over day period. In this subgroup
signifi cant positive correlation between N-proBNP levels and systolic blood pressure over day period was found.

Objective. To estimate target organs state and endothelial function in patients with isolated ambulatory hypertension
at work. Design and methods. 76 patients with hypertension at working place (AHwp) formed the 1st group, 42 patients
with fi rstly diagnosed essential hypertension formed the 2nd group. Offi ce blood pressure (BP) was measured in all subjects.
Also BP monitoring at work and at rest, echocardiography, duplex scanning of brachiocephal arteries, test of brachial artery
temporary occlusion and endothelial function assessment were performed. Results. Patients of the 1st and 2nd groups had
comparable risk factors. Patients with AHwp 24,1 % (p = 0,01) oftener showed diastolic dysfunction of left ventricle (LV).
Intima-media thickness did not differ between groups but atheroma was found more frequently (for 13,2 %, p = 0,01) in
subjects from the 1st group. Subjects with AHwp in comparison with those with essential hypertension rarely had normal
endothelial function (for 26,1 %, p = 0,005), vasoconstrictive endothelial reaction on temporary occlusion was found oftener
(for 30,3 %, p = 0,001) in 1st group subjects. Conclusions. Patients with masking hypertension had comparable rate of main
risk factors, LV hypertrophy and brachiocephal atherosclerosis, but they showed more expressed diastolic dysfunction of
LV and endothelial dysfunction as compared to patients with essential hypertension.

Objective. To study the haemocirculation features in the vessels of target organs (heart, kidneys, brain) and to assess
the association of the functioning systems in the development of hypertension. Design and methods. 93 patients with
hypertension grade I-II aged 50,6 0,6 years and 25 healthy people were included into an open randomized research. The
following parameters were assessed: offi ce blood pressure (BP), the endothelium function, aorta and large arteries stiffness,
the indices refl ecting remodeling of heart, kidney and brain vessels (echocardiography, sonography of kidneys and brain
blood vessels, ALOKA 4000 with the TRIPLEX-scan), microalbuminuria and the rate of glomerular fi ltration. Results.
Hypertension of 1-2 degrees is accompanied by the endothelium dysfunction, the increase of the large vessels and the aorta
stiffness, the decrease of the speed indices of the blood fl ow in kidneys and brain, and the increase of the peripheric resistance
indices (Ri and Pi). Complex correlation between the pulse BP and the indices refl ecting large vessels stiffness, indices of
peripheral resistance at the level of the internal carotid and kidney vessels (р < 0,05) has been established. A direct relation
between the indices of the endothelium dysfunction and BP value, the aorta stiffness degree, the general peripheral resistance
and the intensity of the vessels remodeling (р < 0,05) has been found. Conclusions. Our data demonstrates the variety of
the interdependent relations between the BP value and the indices refl ecting the endothelium dysfunction, the viscoelastic
features of large arteries, the general peripheral vascular resistance and the peripheral resistance at the level of kidney and
brain vessels that confi rms sharing of the functioning systems in the development of hypertension.

The high prevalence of vitamin D defi ciency worldwide and the associated increased risk for different pathologies
require re-evaluation of this problem and its signifi cance. The wide spectrum of the diseases associated with vitamin D
defi ciency explains the high scientifi c interest and increasing number of clinical trials in this area, and the involvement of
larger populations into studies.

During early phylogenesis, each forming paracrine regulated community (future structural and functional units of body
organs) included a pool of specialized cells, elements of the interstitial tissue, and local peristaltic pump. In the community
the pump performed the biological functions of homeostasis and endoecology (purity of the intercellular medium); the
paracrine community regulated the pump via humoral factors. Later on, the development of the biological function of locomotion
required a closed circulation system in which the heart and elastic arteries, as a single functional unit, have united
millions of much more ancient local peristaltic pumps. We suppose that muscular arterioles are these peristaltic pumps, and
the number of paracrine communities equals the number of arterioles in the body. Phylogenetically, arterial bed consists of
two segments: proximal (heart and elastic arteries) and distal (muscular arterioles). Proximal segment is regulated by the
vasomotor center via sympathetic and parasympathetic innervation, and distal segment (peripheral peristaltic pumps) - by
paracrine communities. When the biological function of locomotion is performed, two levels of regulation are coordinated
via the mechanosensitivity of the muscular arteriolar endothelium, thus providing intense cell perfusion. In the realization
of the biological function of homeostasis two mechanisms of regulation are opposing, which is crucial for the pathogenesis
of arterial hypertension.