MODERN APPROACHES TO THERAPY OF ACUTE RESPIRATORY VIRAL INFECTIONS OF THE UPPER RESPIRATORY TRACT

Acute respiratory viral infection(ARVI) are the most common diseases  in the world. Acute respiratory viral infections (ARI), including influenza, include a group of infectious diseases of the respiratory tract with a viral etiology and are predominantly airborne transmission. SARS and flu are manifested in the diversity of respiratory symptoms. One of the rules of the medicine is the desired effect with a minimum number of indicated drugs. However, the patient is forced to administer a number of drugs aimed at the relief of coughing, running nose, headache, decrease in temperature, as well as antiviral, antihistamine and other medications. On the background of such polypharmacy use of combined drugs is reasonable

СARDIOPROTECTION IN PATIENTS WITH HYPERTENSION – THE ROLE OF LOSARTAN

In patients with arterial hypertension (HT) heart is affected earlier and more often than other target organs, left ventricular hypertrophy (LVH) develops. Considering the proven link between the presence of LVH and increased cardiovascular risk, the deterioration of the clinical course and prognosis in HT patients, as well as a significant prognosis improvement in patients with LVH decrease, correction of modifiable risk factors (including uncontrolled HT) is getting extremely important. Organoprotective properties of drugs should be taken into account as one of the important parameters in the consideration of antihypertensive therapy. Major studies conducted in recent years have proven cardioprotective and angioprotective properties of angiotensin receptor blocker losartan, so it can be used as first-line therapy in patients with HT and LVH

Modern Recommendations and Real Clinical Practice: the Results of the SILA Study

Aim. To assess efficacy and safety of single-pill combination (SPC) amlodipine/perindopril and amlodipine/indapamide/perindopril in patients with uncontrolled hypertension (HT) in routine clinical practice.Material and methods. 16144 patients with uncontrolled HT were included into this multicenter observational study. Eventually 6% of patients were excluded owing to violations of protocol. 15193 patients became subjects to the final statistical analysis; they all were prescribed with single-pill combination amlodipine/perindopril or amlodipine/indapamide/perindopril and subsequently purchased these drugs. Study lasted for 3 months; during this time researchers performed office blood pressure (BP) and heart rate measurements on a monthly basis. Additionally, the researchers registered adverse effects and assessed efficacy and safety using 7-point scale.Results. Initially, patients had an average systolic BP of 1 64.2 ± 1 1.4 mm Hg, diastolic BP - 94.8±8.1 mm Hg, and they also had antihypertensive therapy in 85-89% of cases (in different regions). Patients received ACE inhibitors in 50-54% of cases, angiotensin receptor blockers - in 1 9-23%, calcium channel blockers - in 24-31 %, thiazide diuretics - in 29-36%, beta-blockers - in 27-32%. Monotherapy with ACE inhibitors was used in 1 2-18% of patients, and monotherapy with other antihypertensive drugs - in 1 -4%. Mean age was 60.5 years, mean body mass index - 29.3 kg/m2, 43% of patients had a very high risk by SCORE scale. Prescribed therapy: SPCs amlodipine/perindopril (54%) and amlodipine/indapamide/ perindopril (46%) in different doses. By the end of treatment course, the following results have been got: 88% of patients achieved target BP levels (92% and 85% among patients who took SPCs amlodipine/perindopril and amlodipine/indapamide/perindopril, respectively). Systolic BP decreased by 36,6±11,4 mm Hg (22.0±5.9%), diastolic BP - by 15.6±8.5 mm Hg (16.0±8.1%), pulse BP decreased by 21.0±11.4 mm Hg (28.8±13.9%). Mean efficacy assessment rate was 6.9±0.37 points out of 7; mean safety assessment rate was 6.9±0.37 points out of 7. Adverse events were recorded in 257 patients, which constituted 1.7% of the entire patients' population.Conclusion. Using SPC amlodipine/perindopril and amlodipine/indapamide/perindopril is associated with fast achievement of the target BP levels among most patients with a small number of adverse effects

Association of polymorphism of genes of folate cycle and blood serum content of interleukin-33 in patients with high summary cardiovascular risk on the combined therapy of arterial hypertension

Aim. The study of genetic factors of cardiovascular diseases is of great importance, as the screening of major risk factors that cause the development of cardiovascular accidents across the globe does not enable identifying at least half of those who appear to suffer from the diseases in the future. In order to solve this particular problem, an effect of combined therapy of hypertension on the interleukin 33 (IL-33) in patients who appear to be at high risk of developing cardiovascular diseases as well as the presence of polymorphisms of genes of the folate cycle (MTHFR C677T, A1298G, MTR А2756G, MTRR A66G) have been studied. Methods and results. 41 women suffering from arterial hypertension as well as 10 patients at risk of SCORE<5% were examined. Using the enzyme immunoassay, serum IL-33 concentration before and after 6 months of treatment by combined medication (Noliprel A Forte, Servier) was studied. In addition, all the patients underwent the molecular genetic analysis of blood samples. As the result, the patients with arterial hypertension and ones being at high total cardiovascular disease risk showed the increased concentration of IL-33 in blood. Moreover, the relationship between its concentration in blood and polymorphism of gene MTRR A66G was established. Conclusion. This proves the key role of the polymorphism of gene MTRR A66G in influencing the IL-33 concentration index in blood

NOVEL DIRECTION IN ADHERENCE ASSESSMENT — FOCUS ON THE GERIATRIC SYNDROMES

Aim. To investigate on the factors determining the adherence to optimal treatment  in older  age  patients  with chronic  heart  failure (CHF) in outpatient setting.Material and methods. Into the open, comparative single-movement non-randomized  study, 80 CHF patients  were included at the age ≥60 y.o. Comparison group consisted  of 40 patients (18 males, 22 females) with non-CHF cardiovascular  disorders.  Patients  underwent  the comorbidity assessment, laboratory and echocardiographic parameters, 6-minute walking test, cognitive status, treatment adherence, bi-photon x-ray absorptiometry. Criteria for frailty were 3 points by FRAIL (Fatigue, Resistance,  Ambulation, Illnesses, Loss of Weight).Results. The adherent to treatment were 40% of CHF patients, and 75% in comparison  group  (p&lt;0,001).  In monofactorial analysis there  was correlation of treatment  adherence with the level of cognition by Mini-mental  State  Examination — odds  ratio  (OR) 1,5;  95%  confidence interval  (CI) 1,2-1,9  (р&lt;0,001),  frailty  — OR 3,5;  95%  CI 1,3-9,5 (р=0,011),  osteoporosis  — OR  2,98;  95%  CI 1,0-8,9   (р=0,050), comorbidity by Charlson — OR 1,21; 95% CI 1,0-1,5 (р=0,050).Conclusion. Adherent to treatment were 40% of outpatients with CHF at the  age  ≥60  y.o.  Multiple comorbidities,  impaired  cognition  status, osteoporosis, frailty influenced negatively the adherence to treatment in older persons with CHF

THE INFLUENCE OF TREATMENT WITH LOSARTAN AND ENALAPRIL ON POSTINFARCTIONAL LEFT VENTRICLE REMODELING

The influence of treatment with Losartan and Enalapril on postinfarctional left ventricle remodeling

INFLAMMATION ROLE AND ANTI-INFLAMMATORY STRATEGIES IN ACUTE CARDIOVASCULAR PATHOLOGY

In patients with myocardial infarction, the dynamics of acute phase proteins (APP), oxidative stress and white blood cell functional activity was investigated. A statistically significant increase in APP levels was observed starting from Day 1, reached its peak at Day 7, and disappeared by Day 28. Acute phase parameters correlated with oxidative stress characteristics. APP levels were higher in patients with more severe clinical course. The rate of haptoglobin concentration reduction was higher in participants receiving ACE inhibitors, comparing to the control group. Therefore, ACE inhibitor therapy might affect inflammation and sclerosis processes in the infarction area

RUSSIAN EXPERTS’ CONSENSUS ON METABOLIC SYNDROME PROBLEM IN THE RUSSIAN FEDERATION: DEFENITION, DIAGNOSIS CRITERIA, PRIMARY PREVENTION AND TREATMENT

Russian Experts’ Consensus on Metabolic Syndrome Problem in the Russian Federation: Defenition, Diagnosis Criteria, Primary Prevention and Treatment