[The problem of the accurate noninvasive diagnosis of left ventricular myocardial hypertrophy in essential hypertension: the role of magnetic resonance tomography]. / Problema tochnoi neinvazivnoi diagnostiki gipertrofii miokarda levogo zheludochka pri éssentsial'noi gipertonii: rol' magnitno-rezonansnoi tomografii.

MR-tomography was compared to echocardiography for efficacy in diagnosis of left ventricular hypertrophy in 55 patients with stage II essential (WHO criteria). Left ventricular myocardial mass estimated at echocardiography appeared significantly greater than this mass estimated at MR tomography: 244.0 +/- 9.0 g (MRT) and 359.8 +/- 15.6 g (echo-CG), respectively (p < 0.001).

[Arterial hypertension and the antiphospholipid syndrome]. / Arterial'naia gipertoniia i antifosfolipidnyi sindrom.

Antiphospholipid syndrome (APLS) is defined as a symptom complex characterized by arterial and venous thromboses, obstetric abnormalities, thrombocytopenia and hyperproduction of antiphospholipid antibodies. APLS may be primary and secondary developing in the presence of autoimmune disorders, SLE in particular. At examination of 28 patients with primary and secondary APLS 14 patients proved hypertensive. Renal pathology was absent. Arterial hypertension appeared often in combination with microthrombi of the skin and affections of peripheral vessels. Arterial hypertension as a cardiological sign of APLS occurs more frequently than other symptoms.

[The indices of the fibrinolysis, blood coagulation and lipid transport systems in hypertension patients]. / Nekotorye pokazateli sistem fibrinoliza, svertyvaniia krovi i lipidnogo transporta u bol'nykh gipertonicheskoi bolezn'iu.

Lipid spectrum, basal insulin concentration, the activity of coagulation factor VII and inhibitor of plasminogen tissue activator, content of plasminogen tissue activator antigen were assessed in 54 hypertensive patients with left ventricular hypertrophy (mean age 48.9 +/- 0.9 years, mean duration of the disease 15.7 +/- 1.1 years) after discontinuation of hypotensive therapy. A correlation was found between a rise in thrombogenic, atherogenic and a fall in fibrinolytic potential of blood. These findings suggest an essential role of insulin in regulation of thrombogenesis and fibrinolysis in hypertensive patients.

[The manifestations of IHD and the status of the coronary arteries in patients with the antiphospholipid syndrome]. / Proiavleniia IBS i sostoianie koronarnykh aterii u bol'nykh s antifosfolipidnym sindromom.

Of 20 patients with antiphospholipid syndrome 6 were found clinically and upon special tests to have signs of ischemic heart disease. All the 6 had shifts in lipid spectrum of plasma. It is important to study coronary pathology in antiphospholipid syndrome to elucidate mechanisms underlying thrombosis and vascular atherosclerosis in human diseases.

[Evaluation of the efficacy and tolerance of the new delayed-action angiotensin-converting enzyme inhibitor cilazapril in patients with hypertension (preliminary report)]. / Otsenka éffektivnosti i perenosimosti novogo ingibitora angiotenzinprevrashchaiushchego fermenta prolongirovannogo deistviia silazaprila u bol'nykh gipertonicheskoi bolezn'iu (predvaritel'noe soobshchenie).

Cilazapril [correction of Silazapril], a new inhibitor of long-acting angiotensin-converting enzyme, was given to 39 hypertensive subjects aged 24-68 with initial diastolic pressure 95-120 mm Hg. Of them 16 were females and 23 were males. The course of the treatment lasted 8 weeks, the drug being taken daily in a single dose 2.5 mg in the morning. Checkups, measurements of arterial pressure (AP), blood counts, urinalyses were made before the treatment, on the treatment week 4 and 8. In one patient the drug was discontinued 4 weeks after the treatment start because the AP fall to 110/63, in 23 patients the dose was raised to 5 mg, the rest continued on 2.5 mg/day. The treatment ended in the systolic pressure decrease by 14.9% (from 161.0 +/- 2.9 to 137.8 +/- 2.8 mm Hg, p < 0.0001) and diastolic pressure fall by 13.5% (from 104.5 +/- 1.4 to 90.1 +/- 1.7 mm Hg, p < 0.005). No side effects causing the drug withdrawal were registered. It is concluded that the drug is effective in essential hypertension stage IIA-IIB as monotherapy.

[The humoral immunity indices and vascular reactivity of patients with hypertension and an elevated blood lipid level]. / Pokazateli gumoral'nogo immuniteta i sosudistaia reaktivnost' u bol'nykh gipertonicheskoi bolezn'iu s povyshennym urovnem lipidov krovi.

Out of 60 males aged 41 +/- 1 suffering from mild arterial hypertension (158 +/- 4/100 +/- 2 mm Hg) a hereditary load by hypertension was found in 63.3%, serum cholesterol levels reached 200 mg/dl in 85% of the patients. The patients with the load and enhanced Na-Li countertransport (403 +/- 49 mumol Li/1/cell/hr against 185 +/- 28 mumol Li/1/cell/hr in those without hereditary predisposition, p < 0.05) showed a significantly higher serum level of IgA and IgE (3.68 +/- 0.33 g/l and 127 +/- 14 U/ml vs 2.61 +/- 0.33 g/l and 79 +/- 15 U/ml, respectively, in those without the load, p < 0.01, p < 0.05). An IgE level significantly correlated with the amplitude of norepinephrine vascular reactivity (r = 0.35, p < 0.05). The discussion is concerned with IgE hyperproduction significance. Correlating with the amplitude of vascular reactivity on sympathetic stimuli and being independent of hypertension magnitude, this hyperproduction may underlie a high risk of atherosclerosis and vascular complications as a result of IgE-mediated vascular reactions in young subjects with mild hypertension in hereditary loading, erythrocytic accelerated Na-Li countertransport and lipid metabolism derangement.

[The renin-angiotensin-aldosterone system and arterial hypertension in patients with rheumatoid arthritis]. / Sistema renin-angiotenzin-al'dosteron i arterial'naia gipertenziia u bol'nykh revmatoidnym artritom.

Renin-angiotensin-aldosterone++ system was investigated in 60 patients suffering from rheumatoid arthritis. Forty-four of them (group 1) had arterial hypertension (144 +/- 4/94 +/- 2 mm Hg), sixteen were free of hypertension (120 +/- 3/80 +/- 1 mm Hg). Twenty-nine control subjects comparable by AH standing and demographic parameters had essential hypertension stage IB-IIA by A. L. Myasnikov classification (141 +/- 3/89 +/- 1 mm Hg). A tendency to renin suppression was dominating in 72% of group 1 patients (plasma renin activity less than 1.0 ng/ml/h). In this group there appeared high concentrations of A II (14.2 +/- 3.1 pg/ml) and plasma aldosterone++ (238 +/- 94 ng/ml). Rheumatoid vasculitis manifested in 86% of patients. Control subjects exhibited plasma renin activity greater than 3.0 ng/ml/hin 48%, average A II concentration was similar to that of group 1 (12.4 +/- 2.7 ng/ml/h, p greater than 0.05), plasma aldosterone++ level was significantly lower (176 +/- 29 ng/ml, p less than 0.05). Correlations were established between A II concentration and ESR (r = 0.39, p less than 0.05), A II and rheumatoid factor titers (r = 0.40, p less than 0.05). These indicate that immunopathological reactions are responsible for shifts in renin-angiotensin-aldosteron system in hypertensive rheumatoid arthritis subjects.

[The correlation of the indices of humoral immunity and of the activity of the renin-angiotensin-aldosterone system in hypertensive patients]. / Sootnoshenie pokazatelei gumoral'nogo immuniteta i aktivnosti renin-angiotenzin-al'dosteronovoi sistemy u bol'nykh gipertonicheskoi bolezn'iu.

The content of IgA, IgM, IgG and IgE was measured in 55 male patients with uncomplicated essential hypertension (EH) running a labile course (25 patients) and a stable course (30 patients). Analyzing the material, account was taken of aggravated heredity factor as regards arterial hypertension, established according to the anamnesis in relatives of the first degree kinship. A group of patients with the aggravated familial anamnesis as regards arterial hypertension were distinguished. They suffered from labile hypertension with a tendency to hyperreninemia and IgE overproduction, which may be unfavourable in terms of EH progression and development of cardiovascular complications.

[Immunological effects of captopril and ramipril in patients with hypertension]. / Immunologicheskii éffekt kaptoprila i ramiprila u bol'nykh gipertonicheskoi bolezn'iu.

Fifteen patients with essential hypertension underwent treatment with captopril (7 patients) and ramipril (8 patients). The drugs belong to angiotensin-converting enzyme (ACE) inhibitors. Pretreatment immunological examination and that after a 10-15-week course of the above therapy involved measurements of IgG, IgA, IgE and beta 2-microglobulin. The analysis of the trend in the immunological indices demonstrated that captopril, distinct from ramipril by the presence of a sulfhydryl group, caused a decrease in immunological parameters suggesting a potential role of culfhydryl groups in mediating ACE inhibitor action on the immune system. The immunological properties of captopril may appear useful in various systemic diseases.

[Study of the relation of various genetic and pathophysiologic factors participating in the regulation of blood pressure in patients with hypertension]. / Izuchenie vzaimosviazi mezhdu nekotorymi geneticheskimi i patofiziologicheskimi faktorami, uchastvuiushchimi v reguliatsii arterial'nogo davleniia u bol'nykh gipertonicheskoi bolezn'iu.

A study of 35 patients with uncomplicated essential hypertension (EH) (labile hypertension, stages IB-IIA or stable hypertension, stage IIB) demonstrated a higher rate of Na+-Li+ countertransport in patients with hypertensive hereditary predisposition to EH (group 1), as compared to those with unaggravated heredity (group 2). A suppression of plasma renin activity (53%), and a higher rate of hyperlipoproteinemia (55%) were observed in group 1, as opposed to group 2 where Na+-Li+ countertransport was lower, plasma renin activity was normal, and hyperlipoproteinemia occurred in 33%. There was a direct correlation between Na+-Li+ countertransport and renin-angiotensin-aldosterone components in group 2. A conclusion is made that aggravated heredity, RAAS components and hyperlipoproteinemia should be taken into account in the assessment of Na+-Li+ countertransport in hypertensive patients.

[Disorders of humoral immunity in hypertension]. / Narushenie gumoral'nogo immuniteta pri gipertonicheskoi bolezni.

Examination included 51 patients with essential hypertension (EH) of an uncomplicated course, labile (IB-IIA stage, according to A. L. Myasnikov's classification) and stable (IIB stage) hypertension. Clinical characteristics were given to the stages and duration of EH, body weight of the patients, arterial hypertension (AH) heredity and the AP level. Immunological examination included determination of the concentration of the basic classes of immunoglobulins IgG, IgA, IgM, circulating immune complexes (CIC), concentration of IgE and beta 2-microglobulins. It was revealed that EH development is attended by an increased concentration of immunoglobulins, primarily of IgA (23 per cent), IgE (31 per cent) and CIC (21 per cent), which is associated, to a certain degree, with a factor of AH hereditary aggravation.