The сlinical guidelines present the main approaches to the management of patients with arterial hypertension (aH) using the principles of evidence-based medicine. The guidelines include sections containing expanded and updated information on the main aspects of diagnosis, treatment, prevention methods and follow-up patients with hypertension, taking into account the phenotypes of disease and various clinical situations, as well as secondary forms of hypertension of various origins.

Aim. To assess arterial wall stiffness in hypertensive men under 45 years old depending on the presence or absence of obstructive sleep apnea, and regardless of other factors potentially influencing arterial stiffness.

Materials and methods. The study included 75 hypertensive men aged 18-44 years old. all patients underwent general clinical, laboratory and instrumental diagnostics, including biochemical blood test, 24-hour blood pressure monitoring (aBPM), overnight cardiorespiratory monitoring, sphygmography, applanation tonometry.

Results. The mean age of included patients was 35.0 years old [29.0; 40.0]. Patients with obstructive sleep apnea (OSa) (apnea/hypopnea index (aHI) ≥ 5 events/h) were older (38.5 years [35.0; 43.0] vs. 30.0 [28.0; 40.0], p=0.00), more often suffered from obesity (84.4% vs. 30.2%, p=0.00), had higher glucose levels (5.5 mmol/l [5.2; 6.0] vs. 5.1 [4.9; 5.4], p=0.00) and carotid-femoral pulse wave velocity (cfPWV) (8.6 m/s [7.5; 9.8] vs. 7.4 [6.8; 8.2], p=0.00). at the same time, the frequency of dyslipidemia, blood pressure (BP) levels according to clinical measurements and aBPM, as well as other indicators of the structural and functional state of the arterial wall did not differ significantly between the groups. according to ROC analysis and multivariate logistic regression, it was determined that aHI> 4.9 events/h, clinical systolic BP (SBP) > 130 mm Hg, glucose level > 5.1 mmol/l and age > 37 years are independent markers of high risk of increased arterial stiffness in men under 45 years old.

Conclusion. Obstructive sleep apnea, along with age, glucose levels, and elevated SBP, is an independent marker of increased arterial stiffness. To minimize the negative impact of the described factors on arterial wall stiffness, it is important to control SBP and glucose levels, as well as to treat OSa in young men, especially in the age over 37 years.

Objective. ToGlobally more than 1.4 billion people have hypertension, of whom less than 15% have their blood pressure appropriately controlled (BP), and that is the leading cause of death globally. In low- and middle-income countries, more than 70% of the treated patients have uncontrolled hypertension. One of the major reasons for poor control is reliable patient adherence to treatment. fixed-dose combinations, which incorporate two antihypertensive drugs or more can improve control rates BP without increasing the risk of adverse events, and can thereby prevent complications of uncontrolled hypertension.

The advantages of fixed combinations from Canonpharma Production are proven bioequivalence to reference drugs, good tolerability, ease of use and lower cost compared to original drugs. fixed combinations from Canonpharma Production are represented by several two- and three-component combinations of antihypertensive drugs in various dosages, which help physician to prescribe and escalate antihypertensive therapy.