Despite the large arsenal of antihypertensive agents, BP control, both in Europe and in Russia, remains at a low level, more than 50% patients do not reach the goal BP levels. At the same time, data from the results of RCTs demonstrate that the achievement of goal BP values is possible in most patients, no more than 5-10% of patients have resistance to antihypertensive therapy. Sufficient evidence has been accumulated that low adherence to treatment remains a

fundamental contributing factor to insufficient BP control. There is evidence that adherence to treatment closely correlates with the complex dosing regimen of the drugs and the number of tablets taken. Low adherence has been shown to be associated with an increased risk of cardiovascular complications. Furthermore, evidence suggests that medical inertia contributes to treatment failure in patients remaining on monotherapy or receiving inadequate suboptimal therapy. The use of combination therapy, including the use of fixed combinations in most patients, can help to solve both problems. This consensus focuses on various issues related to the prescription of combination therapy in the form of fixed combinations and polypill.

Aim: to study the clinical and demographic characteristics of patients in a sample of patients with arterial hypertension observed in primary healthcare (20192022). To compare data from patients with uncontrolled and controlled hypertension.

Materials and methods. An analysis of medical data of 4543 patients was carried out (history, clinical and laboratory data, concomitant cardiovascular diseases, type 2 diabetes mellitus, chronic kidney disease, revascularization (coronary bypass grafting, transluminal balloon angioplasty of the coronary arteries). For statistical data processing, the SPSS statistical software package was used.

Results. The patients in the study sample were middle-aged and elderly. 51,5% of patients did not achieve target blood pressure values. More than 90% of patients in the studied sample are high and very high risk patients. The ratio of groups of patients with controlled and uncontrolled arterial hypertension among patients of different ages did not differ. Higher values of low-density lipoprotein cholesterol, a higher frequency (1,3 times) of failure to achieve target values of low-density lipoprotein cholesterol <2,6 mmol/l, and obesity (1,3 times) were identified in patients with uncontrolled arterial hypertension. More than 80% of patients had low-density lipoprotein cholesterol values higher than recommended. Patients with controlled arterial hypertension were more likely to have coronary heart disease, myocardial infarction and a history of coronary angioplasty and coronary artery bypass grafting.

Сonclusions. In hypertensive patients, more careful monitoring of cardiovascular risk factors is required, including blood pressure levels and achieving target LDL cholesterol levels. The association of a higher incidence of obesity, type 2 diabetes mellitus and the severity of dyslipidemia with uncontrolled hypertension may indicate less adherence of patients to both drug and non-drug treatment methods. While the presence of coronary heart disease, surgical interventions performed on the coronary arteries can serve as an illustration of increased adherence to therapy when hypertension is combined with coronary heart disease.

Human immunodeficiency virus (HIV) infection is characterized by high morbidity and is a significant threat to human health, increasing global mortality. The number of people living with HIV infection is estimated by the United Nations Joint Program on Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (UNAIDS) to be 39 million (33.1-45.7 million) in 2022. With the introduction of highly effective antiretroviral therapy (cART) into clinical practice and the resulting increase in life expectancy in this cohort of patients, HIV-associated complications have come to the forefront, among which the most severe is pulmonary arterial hypertension (PAH), characterized by a progressive increase in pulmonary vascular resistance and pulmonary artery pressure, leading to the development of right ventricular failure. Subsequently, it became evident that this pathology can occur at all stages of HIV infection and, apparently, has no clear relationship with the degree of immunodeficiency, and is an independent predictor of mortality in patients with LAH-HIV, and therefore requires separate, close attention. This article provides an overview covering the basic pathophysiology, clinical manifestations, diagnosis and treatment of HIV-associated LAH (LAHHIV), emphasizing the challenges encountered at each stage. The review also considers current aspects aimed at studying LAH in patients with HIV, including new experimental drug therapies that take into account the interaction of different regimens with LAH-specific drugs.

Obesity is an independent risk factor оf cardiovascular diseases (CVD), type 2 diabetes mellitus and arterial hypertension (HT). Optimization of CVD control methods is one of the most relevant and urgent problems for Russia. Many studies have shown that body weight correlates with blood pressure, and this relationship is due to complex pathogenetic mechanisms. Therefore, therapeutic approaches in a patient with obesity, metabolic syndrome and HT require consideration of all pathophysiologic changes associated with these diseases. Non-pharmacological treatments such as lifestyle changes including weight loss, following dietary guidelines and increasing physical activity can directly affect of BP levels and improve BP control. A wide range of nutritional interventions are effective in treating obesity and comorbidities, and clinicians must consider all options and provide personalized interventions. The Mediterranean diet, vegetarian diets, DASH-diet, Nordic diet, and low-carbohydrate diets have all been associated with improved metabolic health with or without changes in body weight. Recent evidence reinforce more the role of dietary fiber supplementation to the daily diet in patients with HT and metabolic syndrome, although no evidence of significant benefit has been found. Taking into account national dietary characteristics, we have proposed a study in which we plan to study the effect of the Russian diet with fiber supplementation on metabolic parameters in patients with HT. It is planned to evaluate the effect of diet therapy on indicators of metabolic disorders of intestinal metabolites.

This review presents current data regarding the relationship between hyperuricemia, obesity, diabetes mellitus, lipid disorders and pulmonary arterial hypertension (PAH), chronic thromboembolic pulmonary hypertension (CTEPH). Hyperuricemia is associated with a higher risk of developing of PAH, worse prognosis of PAH and greater severity of the patient's condition. Obesity leads to the development of pro-inflammatory and vasoconstrictor effects, hypoxia, which contributes to the progression of PH, however, the survival rate of patients with PH and overweight or obesity is higher than with normal or reduced body weight. Diabetes mellitus and concomitant insulin resistance are associated with a high risk of hospitalization for right ventricular heart failure and mortality. The presence of PAH is associated with lower values of total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, and probably high-density lipoprotein cholesterol (HDL-C). At the same time, higher levels of LDL-С and HDL-С in PAH and CTEPH determine a better prognosis of the disease.

All metabolic disorders considered have common mechanisms of influence on PH. Further study of their pathogenetic basis will make it possible to develop unified approaches to methods of their correction in patients with various types of pulmonary hypertension.