Uric Acid as a Risk Factor for Cardiovascular Diseases

Recently, hyperuricemia and its association with cardiovascular disease have been receiving more and more attention. The article talks about the role of uric acid in the body, the reasons for its increase and the impact of elevated uric acid levels on the cardiovascular system. The mechanisms of influence of hyperuricemia on the development and progression of cardiovascular diseases are presented. Medicinal and non-drug ways to reduce the level of uric acid in the blood are considered. From non-drug methods, attention is focused on the hypopurine diet, adequate drinking regimen and normalization of body weight. Separately, the effect on the level of uric acid of various drugs used in clinical practice is considered. In the light of current clinical guidelines, the issue of the need to prescribe drug therapy for asymptomatic hyperuricemia is discussed

LIPID-LOWERING THERAPY IN OUTPATIENT PRACTICE (ACCORDING TO THE ARGO-2 STUDY)

Aim. To study the features of lipid-lowering therapy with rosuvastatin in high and very high cardiovascular risk patients in real outpatient practice.Material and methods. Patients ≥30 years, visited internists or cardiologists of district outpatient clinics in the period from October 2013 to July 2014 were included into the study. Each patient fill in questionnaire. Determination of total cholesterol (TC) level was performed without special preparation of the patient using a portable photometric blood analyzer. Doctors prescribed rosuvastatin therapy when indicated, in accordance with the Guidelines, choosing the dose on their own. Repeated TC level was determined after 1 month.Results. TC level was initially determined in 10547 patients. Rosuvastatin treatment was recommended for all patients. Repeated TC level determination was performed in 7897 patients in an average after 33 days. Baseline TC level in them was 6.37±0.89 mmol/l, and after 1 month while taking rosuvastatin – 4.89±0.81 mmol/l (p<0.001). The change of TC level was -22% (p<0.001). The average prescribed dose of rosuvastatin was 11.88±5.1 mg per day. The most often (62.8%) rosuvastatin was prescribed in a dose of 10 mg per day, in 27.3% of patients – 20 mg per day, in 9.2% – 5 mg per day, and only 0.5% of patients took it in the maximal dose.Conclusion. In real clinical practice, rosuvastatin for treatment of patients with high or very high cardiovascular risk is often prescribed in moderate doses and rarely in the maximum dose despite the proven lipid-lowering effect

SYSTOLIC ARTERIAL HYPERTENSION: THE PLACE OF ANGIOTENSIN II RECEPTOR BLOCKERS

Systolic arterial hypertension: the place of angiotensin II receptor blockers

CALCIUM ANTAGONISTS IN CLINICAL PRACTICE: FOCUS ON METABOLIC AND VASCULAR EFFECTS

The efficacy of calcium antagonists widely used in cardiological practice is proved both by placebo-controlled studies and in comparative trials with end-point control. Calcium antagonists are the most effective vasoprotective medicines. In our study we had shown antihypertensive efficacy and ability to improve endothelium function of non-dihydropyridine calcium antagonist, diltiazem (Altiazem RR). Altiazem RR can be drug of choice in wide profile of patients with arterial hypertension, especially in those with concomitant metabolic abnormalities, diabetes mellitus and ischemic heart disease.</p

Topical issues of beta-blockers use in various clinical situations

The article provides a review of the topical issues of beta-blockers use in the clinical practice. Attention of practitioners is drawn to the possibility of using these or other beta-blockers in various clinical situations. Some beta-blockers, especially non-selective ones, have negative effects and cannot be used in certain clinical situations (metabolic syndrome, type 2 diabetes mellitus). Modern super-selective beta-blockers do not have these negative effects and can be widely used in clinical practice, including metabolic syndrome and type 2 diabetes. The review focuses on metoprolol tartrate, which has the most extensive evidence base for efficient treatment of various cardiovascular diseases. Another problem related to beta-blockers is their infrequent use or use at inadequate doses. In this connection, a practitioner should prescribe them at the recommended therapeutic doses in various clinical situations, according to the instructions for use of the drug

IMIDAZOLINE RECEPTOR AGONISTS: DO WE KNOW EVERYTHING ABOUT THEIR CAPABILITIES?

The role of selective I1 imidazoline receptor agonists and moxonidine in particular , in modern antihypertensive therapy is discussed. Moxonidine advantages, namely positive effects on insulin resistance, endothelial dysfunction, lipid profile, and plasma fibrinolytic activity are considered.</p

PREVALENCE OF HYPERURICEMIA AMONG PATIENTS WITH METABOLIC SYNDROME: RESULTS OF THE STUDY IN REAL CLINICAL PRACTICE

Interview of Professor D.V. Nebieridz