Introduction. Arterial hypertension (AH) is the main correctable cause of the development of cardiovascular diseases, leading to dysfunction of many organs, including the heart, blood vessels and kidneys. Lack of adequate control of systolic and/or diastolic blood pressure can lead to life-threatening conditions and death.

The aim of study is to analyze the senior medical students’ knowledge from different regions of Russia in the basic issues of hypertension therapy.

Materials and methods. The article presents the results of the first stage of the PHYSTARH multicenter study (the full name of the project is Physicians’ and undergraduates’ knowledge in arterial hypertension treatment): an anonymous survey among 285 senior medical students from 4 cities of Russia. In this article, the authors analyzed the questions of the second part of the questionnaire.

Results. The average level of correct answers on the questionnaire was 57.7%. The minimum level of correct answers was obtained in questions about the effectiveness of combined therapy, as well as the choice of absolute contraindications to the use of antihypertensive drugs. The maximum level of correct answers was registered in the question about determining the drug to its pharmacological group.

Conclusion. The obtained results testify to the insufficiently level of students’ knowledge in the basic issues of arterial hypertension therapy.

Objective: to study the possibility of a new echocardiographic technology for assessing the effectiveness of myocardial work in detecting cardiotoxicity in patients with breast cancer, depending on the level of blood pressure during anthracycline chemotherapy.

Material and methods: 30 women with triple-negative breast cancer were enrolled, 13 of them (43.3%) had arterial hypertension (AH). All patients underwent standard transthoracic echocardiography with assessment of left ventricular systolic function. The STE method was used to estimate the LV global longitudinal strain (GLS) in a two-dimensional mode. The efficiency of myocardial work was also evaluated.

Results. After chemotherapy in patients with breast cancer the LVEF remained within normal values. After chemotherapy in breast cancer patients revealed a statistically significant decrease in GLS and myocardial work parameters. Also it has been shown that myocardial work parameters seem to better reflect the LV mechanical dysfunction compared to the GLS, especially in patients with breast cancer and high blood pressure.

Conclusion. The first results of the study showed that in breast cancer patients who had high blood pressure at the time of the study, myocardial work parameters better reflect of the LV mechanical dysfunction than the GLS parameter. A new method for evaluating the effectiveness of myocardial work requires further research and study in cancer patients undergoing chemotherapy and radiation therapy.

Relevance. The proportion of angiotensin receptor blockers has increased significantly among prescribed antihypertensive agents. To a large extent, this is facilitated by the emergence of new high-quality generic drugs available to the widest range of patients.

Study objectives. Evaluation of effectiveness and safety of Telmista® (Telmisartan 40 mg, 80 mg, tablets, JSC Krka, d.d., Novo Mesto, Slovenia) and Telmista® H (hydrochlorothiazide + telmisartan 12.5 mg + 40 mg , 12.5 mg + 80 mg, 25 mg + 80 mg, tablets, JSC «Krka, dd, Novo Mesto», Slovenia) in patients with arterial hypertension of 1 and 2 degrees.

Materials and methods. The study included 50 patients, 25 men and 25 women with arterial hypertension of 1–2 degrees. All patients underwent office blood pressure assessment, 24-hour blood pressure monitoring (ABPM), total cholesterol, HDL cholesterol, LDL cholesterol, TG, creatinine, glucose, insulin and glycated hemoglobin levels, HOMA index was calculated, urine microalbumin was determined, LV myocardial mass and LVMI were assessed according to ECHOCG at baseline and throughout the study. BP was re-measured after 4, 8, 12, 16, 20, 24 weeks of therapy, ABPM - after 16 weeks, the rest of the listed examinations - after 24 weeks.

Results. During therapy with Telmista® and Telmista® H, 89% of patients with grade 1–2 AH achieved the target BP level, which was accompanied by an improvement in the metabolic profile, a decrease in LVMI and urinary microalbumin (in 50% of patients), alongside with an improvement in the quality of life after 24 weeks treatment. Thus, due to high antihypertensive and organoprotective efficacy, excellent tolerability and availability, Telmista® and Telmista® can be the drugs of choice in hypertensive patients, especially those with metabolic disorders, to maximize the reduction of cardiovascular risk in this category of patients.

The research purpose: development of a mathematical model for predicting the risk of carotid atherosclerosis in young adults 30-49 years old of Slavic and Korean ethnicity.

Materials and methods. 136 conditionally healthy people of Slavic (n-84) and Korean ethnicity (n-52) were evaluated. The survey was conducted according to the design of ESSE-RF study. A carotid arteries duplex scan has been conducted. The predictive model was developed using the logistic regression method.

Results. Ethnic groups did not differ among themselves in terms of age, smoking prevalence and gender (p > 0.05). In KEG increased levels of apoB containing lipoproteins was revealed (level non-HDL-C in KEG was 5,0 ± 1,1 mmol/l versus 4.0 ± 0.9 mmol/l in SEG (p < 0,001), HDL and apoA did not differ between groups (p > 0,05). The prevalence atherosclerosis of the CA was 28.6% in SEG and 32.7% in KEG (p > 0,05). In average KEG had more pronounced atherosclerotic process in the CA- the total percentage of stenosis in the SEG 40 [20; 50] % vs 51 [29; 59] % in KEG, p =0,044, and the average % of stenoses is 22.5 [20; 25] % versus 25.5 [24.6; 29] % respectively, p = 0.029. Binary logistic regression method was used for developing a predictive model for determine the risk of developing carotid atherosclerosis, the area under the ROC curve was 0.848 ± 0.040 with 95% CI: 0.769–0.927. The model was statistically significant, p < 0,001.

Conclusion. Above referenced model makes it possible to evaluate with high accuracy the risk of developing carotid atherosclerosis on a standard dispensary appointment basis.

Introduction. The prevalence of arterial hypertension (AH) among the adult population of Russia is high; up to 48% of deaths are due to its complications. Recently, prognostic indicators of the electrocardiogram (ECG) have attracted the attention of researchers. One of them is the QRS-T spatial angle (sQRS-Ta).

The aim of the work is to study what clinical, laboratory and echocardiographic parameters are associated with increased sQRS-Ta in patients with AH.

Material and methods. The study included 240 AH patients (48% men), mean age 62 ± 11 years. The study did not include patients with valvular disease, bundle branch block, preexcitation and ventricular pacing. Orthogonal leads were synthesized from digital ECGs in 12 leads and sQRS-Ta was calculated as a spatial angle between the integral QRS and T vectors. sQRS-Ta ≥ 90° was considered enlarged. We assessed the associations sQRS-Ta ≥ 90° with the following indicators by the method of logistic regression: sex; the presence of cardiovascular diseases; 5 age groups; overweight, obesity; smoking; heart rate (HR); systolic blood pressure (SBP), diastolic blood pressure; pulse blood pressure; blood glucose; total cholesterol; end-diastolic dimension (EDD) of the left ventricle (LV), LV wall thickness, relative LV wall thickness, left ventricular myocardial mass (LVMM), LVMM/body surface area (BSA); LVMM/height in the degree of 2,7, the presence of LV diastolic dysfunction.

Results. According to univariate logistic regression, sQRS-Ta ≥ 90° associations were found with age, SBP, obesity, heart rate, LV EDD, LVMM, LVMM/BSA, and LVMM/ height2,7. In multivariate logistic regression models, the contribution of SBP ≥ 140 mmHg (odds ratio (OR) 2,22, 95% CI 1,20–4,10; p=0.01), age 55–64 years (OR 1,87; 1,01–3,44; p=0 .04), increased LV EDD (OR 2,70; 95% CI 1,27–5,72; p=0.01) and HR (OR 2,27; 95% CI 1,10–6,05; p =0.01) was independent.

Conclusions. According to multivariate analysis, independent predictors of an increase in sQRS-Ta in patients with AH were SBP ≥ 140 mm Hg, an increase in LV EDD, HR > 80 beats/min, and age 55–64 years.

The aim is to study the characteristics and quality of drug therapy and recommendations for lifestyle changes in patients with chronic kidney disease and arterial hypertension and, separately, chronic kidney disease and resistant arterial hypertension, observed in primary health care.

Materials and methods. The study was carried out on the basis of the AH registry data (N = 43133; 2005-2019 years). Glomerular filtration rate (eGFR) was calculated using the CKD-EPI formula; renal structure and albuminuria were not evaluated. The analysis was performed using the SPSS software (version 22; SPSS Inc).

Results. Less than half of all patients reached the target SBP values. ACE inhibitors/ARBs were not prescribed as first-line antihypertensive therapy in 18% of patients with stage 3 CKD. ACE inhibitors were more often prescribed to men than women (70,6% and 66,5%), and ARBs (11,9% and 15,6%). The frequency of prescribing ACE inhibitors, thiazide and thiazide-like diuretics remained practically unchanged at GFR ≥ 60 and 60 ≥ GFR < 30 ml/min/1,73m², while the frequency of prescribing ARBs, CCBs, loop diuretics increased with a decrease in glomerular filtration rate. Approximately 60% of patients with hypertension were given advice on nutrition and normalization of body weight (among patients with obesity), about 50% — advice on physical activity and ~50% of smokers received advice on smoking cessation. In patients with hypertension and GFR below 60 ml/min/1,73m², primary care physicians gave advice on lifestyle changes more often than patients with higher GFR. In men with hypertension and 3 stage CKD the incidence of coronary artery disease (2 times), CHF (1,5 times), the incidence of myocardial infarction in history (3,4 times), the incidence of stroke in history (1,9 times) higher than in women. The frequency of the presence of probable resistant hypertension increased up to 23,9% with a decrease of eGFR among patients with uncontrolled hypertension and up to 11% with controlled.

Conclusion. For patients with hypertension and CKD, it is necessary to achieve target values of blood pressure, conduct drug therapy aimed at blocking the RAAS (ACE inhibitors /ARBs), select drugs from the CCB group and diuretics as second and third line therapy. In patients with resistant hypertension the addition mineralocorticoid receptor antagonists is necessary.