[Gender-related features of risk factors for, and age- and gender-related differences in the severity and genesis of chronic heart failure].

AIM: To analyze the gender-related features of the prevalence of chronic heart failure (CHF) in Azerbaijan and to estimate the detection rate and risk factors of this condition in inpatients on the basis of a retrospective follow-up study. MATERIALS AND METHODS: A total of 1824 case histories of CHF patients admitted with a CHF diagnosis to the Azerbaijan Research Institute of Cardiology in 2013 were analyzed. RESULTS: The prevalence of CHF is 51.4% among the patients admitted to the Azerbaijan Research Institute of Cardiology. The major etiological factors of CHF are ischemic heart disease (IHD) and hypertension in 79.9% of the. There are gender-related differences in the pattern of cardiovascular diseases in the patients with CHF: IHD (prior myocardial infarction) and hypertension are more common in men and women, respectively. The incidence of CHF was 56.8% among the men; it was registered in them 1.3-fold more often than in the women; 41% of the patients with CHF were older than 60 years. CHF with a left ventricular ejection fraction of < 45% was diagnosed in 84% of the patients. Among the patients with CHF and preserved left ventricular ejection fraction, the number of women rose up to 22%, which was twice higher than that for the men. CONCLUSION: Substantial differences were found in the etiology of CHF in men and women, as well as in patients of different ages.

[Optimization of pharmacotherapy in patients with essential hypertension with neurohumoral modulators with consideration of data on heart rate variability].

Long-term treatment of patients with essential hypertension (EH) and autonomic dysfunction (sympathicotonia type) with lisinopril in combination with indapamide augmented activity of humoral systems and improved heart rate variability. Addition of a selective beta-blocker bisoprolol to lisinopril/indapamide combination promoted normalization of humoral activity. This gives reason to apply tiered RAAS blockade in order to ensure more effective control of activity of neurohumoral systems in patients with EH ant initial sympathicotonia.

[Endogenous sex hormone testosterone and haemostatic factors in young men after myocardial infarction].

OBJECTIVES: To compare levels of haemostatic factors and sex hormones in young men after myocardial infarction, to study relationship between sex hormones and factors of hemostasis. METHODS: We studied 32 men aged 30-50 years with diagnosis of myocardial infarction. Patients were divided into 2 groups according to age: group 1 - 11 patients aged 30-39 years, group 2 - 21 patients aged of 40-50 years. Levels of sex hormones were measured by IFA. Level of fibrinogen, prothrombin index, plasma recalcification time, fibrinolytic activity, indices of aggregation and disaggregation were also determined. RESULTS: Testosterone level in the group I was more decreased in comparison with the Group 2 and level of fibrinogen was higher in the group 1 (3.9+/-0,7) in comparison with the group II (3.1+/-0.8; p<0.05). Pearsons correlation between estradiol and fibrinogen in the group 1 was 0.613 (p<0.05). No such relationship was found in the group 2. Pearsons correlation between testosterone and prothrombin index was 0,477 (p<0.009). CONCLUSION: Endogenous testosterone level is one of the factors which influence haemostatic system, but this effect is not well-defined and requires further study.

[Antihypertensive efficacy of a low-dose combination of amlodipine and lisinopril in the treatment of arterial hypertension in postmenopausal women].

The present study had the objective to estimate the antihypertensive efficacy of a low-dose combination of amlodipine (5 mg) and lisinopril (equator, Gedeon Richter, Hungary; 10 mg) as well as its influence on the diastolic left ventricular function in the women presenting with arterial hypertension in the postmenopausal period A total of 60 postmenopausal women with grade II arterial hypertension available for the examination were allocated to two groups to be maintained on different therapeutic regimens. The study group was comprised of 40 patients treated with equator, and the control group included 20 patients receiving metoprolol and enalapril (12.5 mg and 10 mg respectively). In the beginning and the end of the study (total duration 6 months), all the patients underwent a comprehensive clinical and instrumental examination that included evaluation of their general clinical condition, 24-hour arterial blood pressure monitoring (BPM), electrocardiography (ECG), and doppleroechocardiography. It was shown that therapy with equator significantly decreased systolic and diastolic arterial pressure (SAP and DAP). Comparative analysis of the results of repeated doppleroechocardiography revealed the improvement of left ventricular diastolic function in the majority of the patients of group 1 (83%). It is concluded that systematic treatment with equator produces a stable hypotensive effect and normalizes circadian rhythms of arterial pressure. Moreover, adequate antihypertensive therapy improves diastolic left ventricular function. Treatment with equator is well tolerated by the patients and causes no serious adverse effects.

[Comparison of the effectiveness of moxonidine and prestarium in postmenopausal women with mild and moderate arterial hypertension].

The subjects of this randomized comparative study were 36 postmenopausal women aged 53.7 +/- 1.4 years, suffering from arterial hypertension (AH). The aim was to evaluate the clinical effectiveness of moxonidine, an imidazoline receptor agonist, and prestarium, an angiotensin converting enzyme (ACE) inhibitor, and their effects on target organs and lipid metabolism. The groups were comparable in age, sex, AH duration, as well as office systolic and diastolic arterial pressure. The study demonstrated comparable hypotensive effects of both pharmaceuticals, although moxonidine had an effect on target organs (left ventricular myocardial hypertrophy). After 6 months of treatment moxonidine significantly lowered left ventricular myocardial mass (12.7% on the average, p < 0.05). The study also revealed a positive effect of moxonidine on lipid exchange variables.

[Various neurohumoral aspects of hemodynamic changes in patients with hypertension after correction of electrolyte disorders]. / Nekotorye neirogumoral'nye aspekty gemodinamicheskikh sdvigov u bol'nykh gipertonicheskoi bolezn'iu pri korrektsii élektro- litnykh narushenii.

Changes in activity of sympathetic-adrenal and + renin-angiotensin-aldosterone systems (SAS and RAAS), hemodynamics and electrolyte metabolism when correcting sodium balance in consideration of their "salt sensitivity" were studied in 83 hypertension stage I and II patients. In moderate restriction of sodium chloride response of the patients was not uniform. "Salt--sensitive" subjects responded positively with improvement of central and peripheral hemodynamics, electrolyte balance in enhanced activity of SAS and RAAS. In salt nonresponders and in paradoxical sensitivity SAS and RAAS show activation, most distinct in paradoxical sensitivity, and worse central and peripheral hemodynamics, electrolyte imbalance.

[Changes in vascular reactivity during the noradrenaline test in patients with hypertension]. / Izmeneniia sosudistoi reaktivnosti pri provedenii proby s noradrenalinom u bol'nykh gipertonicheskoi bolezn'iu.

To study vascular responses and to choose a differential therapy, 51 patients with hypertensive disease underwent a pressor test combined with intravenous epinephrine. The test revealed two types of blood pressure control. In type I responses (normotensive responses), there was a good antihypertensive effect shown by beta-adrenoblockers and/or a course of physical trainings. In type II (hypertensive responses), alpha-adrenoblockers and diuretics proved to be more effective. A relationship was found between the type of responses and the activity of the renin-aldosterone system.

[Clinical effectiveness and a change in the tolerance for physical loading in hypertension patients with a moderate limitation of table salt consumption]. / Klinicheskaia éffektivnost' i izmenenie tolerantnosti k fizicheskim nagruzkam u bol'nykh gipertonicheskoi bolezn'iu pri umerennom ogranichenii potrebleniia povarennoi soli.

Salt sensitivity was measured in 38 patients with first- and second-stage essential hypertension. Patients with high salt sensitivity were identified, in whom moderately limited (to 6 or 5 g daily) dietary salt consumption produced a hypotensive effect. A combination of low-sodium diet and hypotensive drugs in salt-sensitive patients allows diminished dosage of medication. Moderately-limited dietary salt uptake was shown to increase exercise tolerance in patients with essential hypertension.

[Effect of captopril on hemodynamics and physical exertion tolerance in patients with arterial hypertension]. / Vliianie kaptoprila na gemodinamiku i tolerantnost' k fizicheskoi nagruzke u bol'nykh arterial'noi gipertoniei.

The hypotensive effect of captopril was assessed in patients with essential hypertension. Captopril-induced fall in arterial blood pressure was shown to be due to a decrease in total peripheral resistance. Treatment with captopril improved considerably physical stress tolerance, its combinations with a diuretic agent being particularly effective.

[Changes in myocardial function in patients with hypertension during treatment with minipress]. / Izmeneniia funktsional'nogo sostoianiia miokarda u bol'nykh gipertonicheskoi bolezn'iu pri lechenii minipressom.

Altogether 33 patients with arterial hypertension were investigated to study changes of left ventricular systolic phasic analysis, caused by prazosin therapy. Two groups were identified on the basis of these changes: indices in the 1st group (intrasystolic index, myocardial tension index, Blumberger coefficient) improved, in the 2nd group they deteriorated. The antihypertensive effect of prazosin should be assessed not only by the level of BP reduction but also by changes of left ventricular systolic phasic analysis. In the deterioration of indices of left ventricular systolic phasic analysis during a test with single administration of prazosin, antihypertensive therapy should be reconsidered.

[Changes in the hemodynamics and cardiac function of hypertension patients on moderate limited consumption of table salt]. / Izmenenie gemodinamiki i funktsional'nogo sostoianiia serdtsa pri umerennom ogranichenii potrebleniia povarennoi soli u bol'nykh gipertonicheskoi bolezn'iu.

A total of 50 patients with essential hypertension, I-II stages, were investigated to study changes in peripheral and intracardiac hemodynamics and myocardial contractility in moderate restriction of sodium chloride in "salt-sensitive" patients (SSP). In such patients (84% of all examinees) with mild arterial hypertension moderate restriction of SC consumption causes a sufficient antihypertensive effect determined by considerable improvement of peripheral hemodynamic indices and improvement of myocardial pump function and contractility, and in patients with moderate and severe hypertension it potentiates an antihypertensive effect and influence of drug therapy on hemodynamics. In non-SSP moderate restriction in SC consumption was ineffective. A sufficient antihypertensive effect in them resulted from the use of drug therapy at higher dosage than in SSP.