Arterial hypertension is both the cause and the result of the progression of chronic kidney disease, which affects about 10-15% of the population worldwide and the prevalence of which is steadily increasing. As the glomerular filtration rate decreases, the blood pressure level rises respectively. Arterial hypertension (AH) and chronic kidney disease (CKD) are independent and well-known risk factors for the development of cardiovascular diseases, and their combination significantly increases the incidence and mortality from cardiovascular disease. Blood pressure control is the most important factor in slowing the progression of CKD and reducing cardiovascular risk. Currently, there is a place for discussions in the scientific community regarding the target blood pressure levels in patients suffering from CKD. Non-pharmacological methods of treatment can reduce the level of blood pressure in some cases, but do not help to achieve the target values in most of the cases. Patients with hypertension and CKD need combined drug therapy. Certain modern drugs have additional cardio- and nephroprotective properties and should be considered as the first line of therapy. A personalized approach based on evidence-based principles makes it possible to achieve blood pressure control, reducing cardiovascular risk and slowing the progression of CKD. This consensus summarizes the current literature data, as well as highlights the main approaches to the management of patients with hypertension and CKD.

Aim. To study clinical and diagnostic data, risk factors, the state of target organs damage (TOD) and prevalence of clinical associated conditions in patients with a hypertensive crisis and uncontrolled arterial hypertension.

Materials and methods. The study included 297 patients hospitalized at the E.I. Chazov National Medical Research Center of Cardiology over the period from September 2019 to March 2022 with the presence of uncontrolled hypertension (blood pressure (BP) above 140/90 mm Hg while taking antihypertensive therapy). Patients were spread into two groups depending on the increase in the frequency of BP: group 1 (n=149) – uncontrolled hypertension with a hypertensive crisis (increase in BP 1 or more per week and/or the presence of severe clinical symptoms), and group 2 (n=148) – uncontrolled hypertension (increase in blood pressure more than 140/90 mm Hg less than 1 per week and/ or without severe clinical symptoms). The presence of risk factors in these groups was analyzed. At the baseline and after 12 months, the presence and severity of TOD (left ventricular mass index (LVMI), chronic kidney disease (CKD), severe retinopathy), history of/occurrence of clinical associated conditions were assessed.

Results. There are significant elevated levels of uric acid, triglycerides, body mass index, heart rate, blood pressure indicators among the risk factors in the group of patients with hypertensive crisis. Patients in the group 1 showed higher rates of LVMI at the baseline and during follow-up for 12 months (baseline – 107±28 g/m2, after a year of follow-up 112±27 g/m2). The glomerular filtration rate (GFR) is lower in patients with hypertensive crisis (initially – 81.5±19.04 ml/min/1.73m2, after 12 months of observation 74.8±18.06 ml/min/1.73m2). There are significant differences in coronary artery disease, atherosclerosis of the brachiocephalic arteries, type 2 diabetes mellitus (DM 2) among clinical associated conditions. After 12 months of observation, acute cerebrovascular accident, coronary artery disease and diabetes occur more often in group 1.

Conclusion. Uncontrolled hypertension with a hypertensive crisis manifestation is a release of hypertension associated with severe TOD and a high prevalence of clinical associated conditions.

Background. The population of patients undergoing large joints arthroplasty has a high prevalence of comorbidities, such as hypertension and other cardiovascular diseases, obesity, diabetes, chronic kidney disease, etc., that are independent risk factors for the postoperative complications, especially of the thromboembolic events.

Aim. To evaluate the prevalence of hypertension and other risk factors in patients undergoing large joint arthroplasty in real-world practice.

Materials and methods. The study included an unselected sample of patients (n=82) who underwent arthroplasty of large joints in December 2022 at the Clinic of Traumatology, Orthopedics and Joint Pathology of the I.M. Sechenov First Moscow State Medical University. A detailed history was collected from all patients and, if necessary, a laboratory and instrumental examination was performed to assess the presence of target organ damage.

Results. Sixty-two patients (81.7%) had hypertension; among them 12.6% had no previous antihypertensive therapy. The average body mass index (BMI) was 31.3±5.2 kg/m2 confirming the high prevalence of obesity in this population. All obese patients had concomitant hypertension (n=62), and 6 people (7.3%) with a BMI over 40 kg/m2 had signs of obstructive sleep apnea syndrome. Diabetes mellitus (DM) was diagnosed in 13 people (15.9%); in all cases it was type 2 diabetes. Chronic kidney disease (CKD) stage 2-4 was diagnosed in 67 people (81.7%), and all these patients had concomitant obesity and hypertension.

Conclusion. Based on the analysis of published literature and a sample of patients from real-world practice, the main population undergoing the arthroplasty of large joints include elder patients, and the vast majority of them have multiply comorbidities (obesity, hypertension, CKD) that are not only the independent risk factors for poor prognosis, but also exacerbate the other concomitant conditions and further increase the risk of complications. It is necessary to conduct large prospective studies with specific evaluation of various cohorts of patients undergoing arthroplasty of large joints including a pharmacoeconomic analysis to determine the need and scope of further examination in this population with a high risk of perioperative complications.

Objective: To determine the frequency of detection of chronic obstructive pulmonary disease (COPD) and Asthma in patients who are admitted to specialized cardiological hospital with arterial hypertension (AH), including AH with chronic heart failure (CHF), coronary heart disease (CHD), cardiac arrhythmias. Analyze the possibility of early diagnosis and the validity of the modified questionnaire for screening risk factors and symptoms of broncho-obstructive pathology in patients with arterial hypertension.

Materials and methods: The sample (n = 1000) consisting of individuals over the age of 18 who continuously arrive for inpatient treatment at the admission department of the National Medical Research Center of Cardiology with arterial hypertension, incl. AH with CHF, IHD and arrhythmias in the period from 2018 to 2019. Active identification of broncho-obstructive pathology among all persons was carried out (history taking, complaints), analysis of medical documents provided by patients (conclusions from outpatient and reference cards of the patient), screening of risk factors and symptoms of broncho-obstructive pathology (a modified questionnaire was used), external respiration function was assessed (computer spirometry), filled out the specialized respiratory questionnaires (CAT, mMRC, ACT).

Results: The undiagnosed broncho-obstructive diseases was demonstrated against the background of their high occurrence in patients with hypertension, incl. CHF, coronary artery disease, NRS entering a specialized cardiological hospital. The study established the most likely predictors of airway obstruction in patients with hypertension, which signal the need to assess the function of external respiration (computed spirometry).

Conclusions: The development and validation of a modified questionnaire makes it possible to identify specific symptoms and risk factors for bronchoobstructive diseases against the backdrop of their high prevalencre among patients who are admitted to cardiology hospital with arterial hypertension.