[Effect of atorvastatin on pro-inflammatory status (in vivo and in vitro) in patients with essential hypertension and metabolic syndrome].

AIM: To study effect of atorvastatin on spontaneous production of cytokines and reactive oxygen species by mononuclear leukocytes of blood of hypertensive patients with metabolic syndrome in vivo and in vitro. MATERIAL AND METHODS: We conducted an 8-week open prospective study on 36 patients with essential stage II hypertension associated with metabolic syndrome. Along with examination made in specialized cardiological clinic we assessed spontaneous production of cytokines and reactive oxygen species by blood mononuclear leukocytes during therapy with atorvastatin (in vivo). Dynamics of these parameters under the influence of atorvastatin on suspension of mononuclear leukocytes was also assessed in vitro. RESULTS: Therapy with atorvastatin (20 to 40 mg/day) facilitated reduction of serum concentration of acute phase proteins (C-reactive protein and neopterin) and decrease of spontaneous production by blood mononuclear leukocytes of proinflammatory cytokines (interleukin [IL]-1ß, IL-6 and tumor necrosis factor [TNF]-α) and reactive oxygen species. Dynamics of cytokine concentrations in supernatants of mononuclear leukocytes obtained after incubation of the cells with atorvastatin in vitro confirmed the assumption of direct inhibitory effect of this drug on spontaneous production of some proinflammatory cytokines (IL-6 and monocyte chemotactic protein-1). Absence of significant lowering of concentrations of other proinflammatory cytokines (IL-1ß and TNF-α) and expression of reactive oxygen species in vitro evidenced for complex indirect effect of therapy with atorvastatin on their production.

[Pleiotropic effects of atorvastatin and dynamics of quality of life characteristics in patients with hypertensive disease and metabolic syndrome].

AIM: To study pleiotropic effects of atorvastatin during 8-week therapy of metabolic syndrome and estimate their relationship with dynamics of quality of life characteristics (QLC). MATERIAL AND METHODS: This 8-week study included 36 patients with stage II hypertensive disease associated with metabolic syndrome (MS). Comprehensive clinical, laboratory and instrumental examination was supplemented by QLC assessment using the MOS SF-36 questionnaire. RESULTS: 8-week therapy of stage II hypertensive disease associated with metabolic syndrome using individually selected doses of atorvastatin (20 to 40 mg/d) significantly reduced atherogenic cholesterol fraction and serum leptin levels; it had positive effect on carbohydrate and purine metabolism and safely maintained positive dynamics of subjective assessment of most points of the MOS SF-36 questionnaire.

[Prothrombotic state in patients with metabolic syndrome: an association with inflammation].

AIM: To comprehensively study hemostasis pathology and its association with the laboratory markers and mediators of inflammation in patients with metabolic syndrome (MS). SUBJECTS AND METHODS: One hundred and eleven patients with type 2 diabetes mellitus, who were diagnosed as having MS, were examined. Vascular-platelet and secondary hemostases and anticoagulant and fibrinolytic systems were evaluated, by performing the complete clinical, laboratory, and instrumental study accepted in a specialized endocrinology clinic. The blood concentrations of high-sensitivity C-reactive protein and proinflammatory cytokines were determined in all the patients with MS and control persons (n = 50). RESULTS: It was found that in patients with MS, hemostasis pathology that might be classified as the combined form of a prethrombotic state, which was caused by different types of a constellation of vascular-platelet and plasma hemostases, as well as physiological anticoagulant deficiency, was linked to the laboratory markers and mediators of subclinical inflammation. CONCLUSION: In the patients with MS, subclinical systemic inflammation is of substantial importance for the mechanisms of a prethrombotic state.

[New aspects of using dihydropyridine calcium antagonists during coronary bypass surgery].

AIM: To study the contractile properties of the human radial artery (RA) and to provide a comparative clinical assessment of the results of autoarterial coronary bypass surgery (AACBS) using calcium antagonists (CA). MATERIALS AND METHODS: Human RA smooth muscle samples (n = 49) taken at AACBS were experimentally studied. Mechanography was used to record the contractile responses of isolated smooth muscle samples to the contractile properties of a RA segment exposed to the liquid vasodilators nifedipine, papaverine, and sodium nitroprusside. The study enrolled 106 patients who had undergone surgical revascularization applying 2 autoarteries or more. Dihydropyridine CAs, such as adulat, norvask, and felodip, were administered by the developed protocol. RESULTS: Adalat experimentally showed a pronounced dose-dependence of vasodilation and long-term aftereffects, which allows the CA to be regarded as the most attractive agent for the intraoperative preparation of an autoarterial shunt. CONCLUSION: The systemic use of a dihydropyridine CA in a clinical trial could reduce the incidence of early autoarterial conduit dysfunction and improve prognosis in the patients.