[The treatment of severe arterial hypertension in patients with chronic kidney failure with captopril and beta-adrenoblockaders]. / Lechenie tiazheloi arterial'noi gipertenzii u bol'nykh s khronicheskoi pochechnoi nedostatochnost'iu kaptoprilom i beta-adrenoblokatorami.

Twenty nine patients with chronic renal failure associated with severe essential hypertension, 10 of whom being on programmed hemodialysis, were treated with captopril, a converting enzyme inhibitor (n = 21) and sectral-400, a cardioselective beta-blocker (n = 11). Blood pressure (BP) changes and renin-angiotensin-aldosterone system parameters were studied by radioimmunoassay. When given in a daily dose of 25 to 100 mg for a long time, captopril provided a good and satisfactory antihypertensive effect in 9 patients; a weak or no effect was achieved in 9 and 5 patients, respectively. BP lowered by an average of 14.7%. There were 72% and 17.9% increases in active and total renin levels, respectively, and a reduction in the proportion of inactive in total renin. With sectral-400, 400-1200 mg/day, good, weak or no effects were observed in 6, 3, and 2 patients, respectively. BP decreased by an average of 13%, there were 59% and 12% reductions in active and total renin levels, respectively, whereas the content of inactive renin showed a 21% increase, suggesting a diminution of renin synthesis and activation. The initially higher plasma aldosterone levels in most patients (by an average of 4.2 times) decreased significantly by 23% with the two drugs. Thus, in severe essential hypertension it is advisable to use blockers of the renin-angiotensin system in patients with chronic renal failure, captopril is particularly indicated in those who have a high renin activity, and the hyperkinetic syndrome is an additional indicator for sectral-400 use.

[Use of the new hypotensive agent Minipress (prazosin hydrochloride]. / Primenenie nocogo gipotenzivnogo sredstva minipress )prazosin hydrochloride).

Efficacy of minipress in patients with hypertension stage II and its haemodynamic effects were studied after a single administration and during a course of treatment. It is shown that its main mechanism is in vasodilatation caused by relaxation of the muscular component of arterioles. The authors suggest that minipress can produce redistribution of the blood through peripheral venoconstriction. Decrease of the index of the external work of the heart points indirectly to decreased oxygen utilization by the myocardium which may reflect changes in haemodynamics under the influence of minipress or through direct action of the drug on the heart. Hypotensive effect of minipress is recorded already by the 5th day of its administration (p less than 0.001), however, its further effect is unstable. Increase of the circadian dose becomes necessary and also its combined use with thiazide diuretics. Positive chronotropic effect of Minipress has been recorded, with maximum towards the end of the 2nd week of treatment and seen as increased rate of cardiac contractions by 13.2% (p less than 0.01). To decrease this effect authors advise to use minipress in combination with beta-adrenoblockers.

[Effect of a bicycle ergometer load on the state of the sympathetic-adrenal system and hemodynamic indices in highly trained athletes]. / Vliianie veloérgometricheskoi nagruzki na sostoianie simpatiko-adrenalovoi sistemy i pokazateli gemodinamiki u sportsmenov vysokoi kvalifikatsii.

The effect of the bicycle-ergometry load on the condition of the sympatheticoadrenal system, the values of cardio- and hemodynamics, and some biochemical indices of metabolism was studied in 36 athletes. Study of the activity of the sympatheticoadrenal system in a complex with the functional and biochemical values during bicyle-ergometry load made it possible to appraise the condition of the adaptive reactions of the athlete's organism during muscular activity and to diagnose in time and prevent a state of physical overstrain.