[Impact of antihypertensive therapy on clinical status and quality of life in patients with initial manifestations of hypertensive encephalopathy].

AIM: To study the clinical and instrumental characteristics of hypertensive encephalopathy (HE) in early stages, as well as the time course of their changes during long-term antihypertensive therapy (AHT). SUBJECTS AND METHODS: Prior to and after 9-month AHT, 57 patients aged 50-70 years who had uncomplicated grades 1-2 arterial hypertension (AH) with grades I-II HE underwent comprehensive examination comprising the studies of cognitive functions, quality of life (QL), hemorheology, and hemostasis, duplex scanning of great and intracerebral vessels, echocardiography, 24-hour blood pressure monitoring, magnetic resonance imaging. RESULTS: Early-stage HE was characterized by more cerebral complaints, higher rates of hypertensive crises, a greater degree of psychoautonomic syndrome, and worse QL. Focal brain lesions were detected in 74%; left ventricular hypertrophy (LVH) was diagnosed in 61% of cases. All the patients were observed to have cognitive dysfunctions. AHT (amlodipine, lisinopril) produced a good antihypertensive effect and substantial improvements of the patients' cognitive functions, health status, and QL. LVH regression was achieved. CONCLUSION: HE is a clinical manifestation of damage to the brain as the principal target organ in AH and should be therefore kept in mind in estimating the cardiovascular risk. The diagnosis of HE requires the use of tests to evaluate cognitive functions.

[Epidemiology, clinical features and betaserc therapy of vertigo in initial and reversible cerebrovascular pathology].

The study comprised two sections: epidemiologic and clinical. The aim of the epidemiologic investigation was to determine prevalence of vertigo, including its mild cases, in patients with initial and reversible forms of cerebrovascular pathology. While screening an open population, 726 men and women aged 35-60 years have been examined using uniform program. Vertigo was detected in 30%, frequent and long-lasting one in 14.6% cases (8.1% men and 21.9% women, p < 0.001). A clinical section included a profound examination of 40 patients. Along with duplex scanning of major brain arteries, neurologic and otoneurologic examination of the patients, aucoustic stem evoked potentials have been registered. Marked dysfunctions of autonomic nervous system and changes in functioning of different vestibular analyzer regions were revealed. High efficacy of betaserk used during 2 months in dosage 16 mg three times a day was demonstrated by improvement of the patient's state in 97% cases.

[Response of the human body to heliogeophysical disturbanes]. / Reaktsiia organizma cheloveka na geliogeofizicheskie vozmushcheniia.

A correlation between variations in the medical parameters and the heliogeophysical indices describing physical processes during solar storms was established. It was proposed that one of the reasons for the biotropic effects observed is rheological shifts of human blood during enhancement of solar activity. The influence of heliogeophysical disturbances on the rheological properties of blood was investigated.

[Prognostic value of the degree of night decrease of systolic pressure in patients with mild and moderate forms of hypertension (7-9-year prospective study)]. / Prognosticheskaia tsennost' stepeni nochnogo snizheniia sistolicheskogo arterial'nogo davleniia u bol'nykh s miagkoi i umerennoi formami gipertonicheskoi bolezni (7-9-letnee prospektivnoe nabliudenie).

AIM: To study a relationship between a carcadian blood pressure (BP) rhythm and cardiovascular events (CE) during 7-9 year follow-up in males with mild to moderate essential hypertension (EH). MATERIAL AND METHODS: 50 males (mean age 48.6 +/- 0.7 years) with mild to moderate EH were prospectively followed up for 7-9 years (8.4 +/- 0.1 years). We analysed 24-h BP recordings and protocol of echocardiography performed during the first hospitalization. The patients were divided into three groups: group 1 (n = 18) with normal (10-20%) nocturnal fall of systolic BP (NF SBP) and normal left ventricular mass index (LVMI < 125 g/m2); group 2 (n = 16) with insufficient (< 10%) NF SBP and normal LVMI; group 3 (n = 16) with LVMI > 125 g/m2. In these groups we assessed the prevalence of CE: myocardial infarction (MI), stroke (S), sudden death (SD), new cases of angina pectoris (AP), transient cerebral ischemic attack (TIA). RESULTS: No significant differences were found between the groups by mean age, body mass index, duration of arterial hypertension, mean 24-h and awake systolic and diastolic BP while significant differences were by nighttime BP profile parameters. During the follow-up 16 CE in 12 patients were documented (3 fatal and 13 nonfatal). In group 1 CE were observed in 1 patient (twice MI), in group 2-7 cases of CE (1 S, 1 TCIA, 2 MI, 2 AP) in 6 patients, in group 3-7 cases (2 MI, 3 TIA, 2 AP) in 5 patients, 3 of them were fatal. CONCLUSION: Insufficient nocturnal fall of SBP (< 10%) is an adverse prognostic factor for cardiovascular morbidity in mild to moderate essential male hypertensives.

[The pathology of catecholamine metabolism in cerebrovascular diseases]. / K patologii metabolizma katekholaminov pri tserebrovaskuliarnykh zabolevaniikh.

Blood catecholamines were investigated with high-performance liquid chromatography and electrochemical detection in 95 patients with cerebrovascular affections. On day 1-3 since ischemic apoplexy blood norepinephrine and dopamine levels increased significantly. This is possibly due to their active release from neurons in brain tissue ischemia. High blood catecholamines are thought an unfavourable factor aggravating the disease and responsible for cardiac sequelae. Ways of cerebral tissue protection in case of ischemia are suggested.

[Effectiveness of a stroke prevention program in a high-risk group]. / Effektivnost' programmy preduprezhdeniia insul'ta v gruppe povyshennogo riska.

As a result of screening of males born in 1922-1931 (n = 2435) a group with a high risk for stroke development (n = 620) was identified. A total of 430 of these patients were followed up for 2 years. At the final stage the authors collected data on 80% of the patients who had undergone the primary examination and carried out a new screening of age-matched males. The morbidity rate related to cerebral stroke was 2.59% in the high risk group and 1.48% in the remaining population. The incidence of myocardial infarction in the above two groups was 5.01% and 1.80% respectively. At the same time 55.9% of new cases of cerebral stroke and 44.2% of myocardial infarction occurred in individuals who were not included into the high risk group and had an "intermediate" risk of the development of these diseases. It is concluded that the problem of combating cerebral stroke cannot be solved by putting emphasis exclusively on prevention in high risk groups and that it should be combined with wide-scale prophylactic work among the population.