Twenty-four-hour profile of peripheral and central blood pressure in young patients with high-normal blood pressure and hypertension

Aim. To evaluate indicators of daily monitoring of peripheral and central blood pressure in young patients with high-normal blood pressure (HNBP) and essential hypertension (HTN).Material and methods. One hundred twelve patients with HNBP or untreated hypertension aged 25-44 years were included. General clinical investigations were performed. An office blood pressure (BP) were assessed using an automatic BP monitor OMRON M2 Basic. Twenty-four-hour ambulotary BP monitoring (ABPM) on the brachial artery and aorta was carried out for 24 hours using the BpLAB system (OOO Petr Telegin) with an integrated Vasotens system. Depending on BP, patients were divided into groups: with HNBP and hypertension. Statistical processing and comparative analysis of the obtained data were carried out.Results. HNBP group consisted of 47 patients, while the HTN group consisted of 65 patients. The mean age of patients was 34,7±3,2 years. The parameters of daytime and nighttime peripheral BP had significant differences between the HNBP and HTN groups. Aortic BP monitoring revealed following differences: in patients with HTN, central BP values during the day and at night reflected higher values compared to patients from the HNBP group. The number of dippers for peripheral systolic blood pressure (SBP) was more by a quarter (p=0,038) in the HNBP group than in the HTN group. There were no differences in the reduction of diastolic blood pressure (DBP). The reduction in aortic SBP between the groups of HNBP and HTN were comparable. Among hypertensive patients, DBP dippers on the aorta were 20% higher (p=0,04) than in the HNBP group. According to the augmentation and the amplification index reduced to heart rate, there were no significant differences between the groups.Conclusion. Intergroup and intragroup differences were revealed depending on the types of 24-hour profile depending on peripheral and central BP. Reference values and predictive value of central BP require further research

Recurrent left atrial rhabdomyosarcoma: a case report

Cardiac tumors are rare, and their diagnosis is a clinical problem associated with significant heterogeneity of pathology. The purpose of this publication is to report a rare known disease and analyze the problem for the purpose of medical education. In a case report, the following characteristic signs of a heart tumor were demonstrated: rapid progression of heart failure symptoms, systemic manifestations (anemia, severe weakness). The results of transthoracic and transesophageal echocardiography made it possible to interpret the intracardiac mass as a tumor recurrence. Histological examination confirmed the diagnosis of left atrial rhabdomyosarcoma. A specific of this case is the tumor recurrence 2 years after surgery

ELECTRICAL INSTABILITY OF MYOCARDIUM IN YOUNG MEN WITH ARTERIAL HYPERTENSION AND OCCUPATIONAL STRESS

Aim. To evaluate prevalence of electrical instability of the heart in persons with stressogenic professions by a complex evaluation of the parameters of clinical and functional methods of investigation.Material and methods. Totally 154 men included with AH of I-II stages; first group consisted of 78 motormen and their assistants having stressogenic profession, second grup consisted of 76 persons with minimal psychoemotional tension. A clinical and functional investigation was performed.Results. In 1st group "possible existence" of delayed atrial and ventricular potentials was twice and three times (resp.) more prevalent comparing to the 2nd (with p=0,0001 and p=0,0002, resp.). A rigid circadian index in the 1st group was 1,7 times more prevalent (Х2=10,5; p<0,001). In those having AH with concomitant chronic gastritis and gastric or duodenal ulcer disease the circadian rigidity was 1,6 times more prevalent (x2 =5,9; p<0,05) in the 1st group. In first stage AH the shift of vagosympathetic balance to sympathic type is more common for the 1st group than for the 2nd.Conclusion. In young men with AH and occupational stress comparing to men with low — stress profession the signs of electrical instabilty are more common

Research on physical and chemical properties of the drug “Ferlatum”

A drug “Ferlatum” (ferric proteinsuccinylate) is a very sustainable ferric proteinaceous complex, in which iron with oxidation state of +3 can`t be detected by trilonometrical method in an aqueous solution even with concentration of 5 mg/l and can`t be reduced by iodide ion within acidic medium into the oxidation state of +2. Efficacy of the drug may be increased by simultaneous admission of ascorbic acid.Лекарственный препарат (ЛП) “Ферлатум” (железа (III) протеин сукцинилат) – очень прочный железо-протеиновый комплекс, в котором степень окисления железа (+3) не определяется трилонометрическим методом даже при концентрации ЛП в водном растворе 5 мг/л и не восстанавливается иодид-ионом в кислой среде до железа со степенью окисления +2. Более эффективному применению ЛП будет способствовать его употребление совместно с препаратами аскорбиновой кислоты или продуктами, содержащими ее

Experience of managing a comorbid patient with chronic heart failure and chronic right-single kidney disease

The aim of the study was to demonstrate on clinical example the peculiarities of comorbid patient management with combined cardiovascular and renal pathology.Цель исследования – продемонстрировать на клиническом примере особенности ведения коморбидного пациента с сочетанной патологией сердечно-сосудистой системы и почек

Monitoring the composition of the oral fluid in the inhabitants of industrial areas

Residents of industrial cities are under the influence of man-made environmental factors. Harmful chemicals, including those containing lead and cadmium, are found in the oral fluid, hard tooth tissues, dental plaque, tissue biopsy specimens. One of the manifestations of the negative effects on the body is the development of caries and inflammatory periodontal diseases. To monitor the composition of the oral fluid of residents of ecologically unfavorable areas, it is advisable to use the method of mass spectrometry with inductively coupled plasma. Based on the analysis of the composition of the oral fluid, it is advisable to personalize the approach in the selection of personal hygiene products of the oral cavity.Жители промышленных городов находятся под влиянием техногенных факторов окружающей среды. Вредные химические вещества, в том числе содержащие свинец и кадмий, обнаруживаются в ротовой жидкости, твердых тканях зуба, зубных отложениях, биоптатах тканевых структур. Одним из проявлений отрицательного воздействия на организм является развитие кариеса и воспалительных заболеваний пародонта. Для мониторинга состава ротовой жидкости жителей экологически неблагоприятных районов целесообразно использовать метод масс-спектрометрии с индуктивно связанной плазмой. На основании анализа состава ротовой жидкости целесообразно персонифицировать подход в выборе средств индивидуальной гигиены полости рта

Atrial fibrillation and gastrooesophageal reflux disease: association mechanisms, treatment approaches

The article is devoted to assessing the relationship of atrial fibrillation (AF) and gastroesophageal reflux disease (GERD). We studied possible anatomical correlations, common risk factors and mechanisms of AF development in patients with gastroesophageal reflux. We demonstrated the problems of the treatment of such patients, since a number of studies have proved the possibility of using proton pump inhibitors in the treatment of AF. In other cases the arrhythmogenic effect of these drugs was obtained. Treatment of AF by catheter ablation most commonly worsens the course of GORD and can lead to the development of fatal complications. Large-scale prospective researches are needed for further detailed study of AF and GERD associations, as well as tactics for management of these patients

Adverse Reactions of the Cardiovascular System when Taking Nonsteroidal Anti-inflammatory Drugs and Ways to Reduce Them

The most important issue of modern pharmacotherapy is not only efficacy, but also the safety of medicines. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is one of the main methods of treating acute and chronic pain in a wide range of diseases and pathological conditions. However, the prescription of this group of drugs requires consideration of the potential risks of complications, including from the side of the cardiovascular system. The purpose of the review was to assess the adverse reactions of the cardiovascular system when taking NSAIDs and approaches to their reduction. The article presents data on the mutual potential impact of cardiovascular diseases and musculoskeletal system, presents the results of large-scale studies of Russian and foreign authors and meta-analyzes of the NSAIDs effect on blood pressure profile, development of myocardial infarction, stroke and heart failure. The possible pathogenetic mechanisms of the side effects of NSAIDs are reviewed; the complexity of managing comorbid patients is demonstrated; it is shown that symptomatic treatment of pain and inflammatory syndrome should be carried out considering a personalized approach to the patient and rational choice of drugs.Before the NSAIDs prescription, it is necessary to consider all cardiovascular risk factors with the determination of the total risk of cardiovascular complications. In patients with a very high cardiovascular risk, the use of any NSAIDs should be avoided; with high and moderate risk, the use of NSAIDs with the most favorable cardiovascular safety profile is possible. If the patient belongs to the category of low total coronary risk, the doctor can choose any NSAIDs

INCREASED STRESS-REACTIVITY OF MALES WITH HIGH NORMAL BLOOD PRESSURE AND HYPERTENSION: INFLUENCE ON THE VESSELS

Aim. To assess stress-reactivity of males younger than 55 y. o. with high normal blood pressure (HNBP) and arterial hypertension (AH) and possible influence on asymptomatic atherosclerosis and arterial stiffness.Material and methods. Into the study, males were included of age 40-55 y. o. According to blood pressure level (BP), they were selected to groups: 1st group included 91 men with HNBP, 2nd — 89 men with the diagnosed AH and reached target BP. The cardiovascular risk factors were assessed, as intima-media thickness of brachiocephalic vessels (BCV), velocity of carotid-femoral pulse wave. Stress-test was done with the “mathematic count”, and the increased reactivity was defined as increase of systolic blood pressure (SBP) and/or heart rate (HR) by >7% and >10%, respectively, during the test. Statistics was done with Statistica 6.0 (StatSoft Inc.).Results. An increased stress-reactivity was found in 34,7% of patients with HNBP and 22,5% with AH. Abdominal obesity patients had higher increase of SBP and HR by 4,1% (p=0,01) and 5,8% (p=0,01), respectively. Higher SBP had smokers, by 4,3% (p=0,001), dyslipidemic males, 6,0% (p<0,001) and those with early cardiovascular anamnesis, by 35,0% (p=0,001) comparing to those with no studied risk factors. Signs of atherosclerosis of BCA had 46,8% and 70,0% males in 1st and 2nd groups with excessive BP reaction to stress-test, and those studied, with normal reactivity had it rarer by 35,7% (p=0,02) and 33,2% (p>0,05). Arterial stiffness was found in 53,1% and 75,0% of men from 1st and 2nd groups with increased stress reactivity, that is more prevalent 6,1 times (p<0,001) and 2,8 times (p=0,001) comparing to normal reactivity in HNBP and AH, respectively.Conclusion. The negative influence was found of the increased stress-reactivity of BP to vessel wall in men with HNBP and AH, and such influence does result not only to early atheroscleoris, but to arterial rigidit

Target organ damage in stress-induced arterial hypertension

Aim. То investigate the features of target organ damage in patients with stress-induced arterial hypertension (AH).Material and methods. The study included 329 men, aged 29—55 years, with Stage I-II AH. Group I consisted of 197 individuals with workplace AH (WAH), Group II — of 132 patients with essential AH (AH); mean age was 41,3±1,4 and 42,5±1,5 years, respectively. All participants underwent Doppler echocardiography and brachiocephalic (BC) duplex scanning.Results. Left ventricular hypertrophy (LVH) was diagnosed in 38,1 % and 28,1 % of the patients from Groups I and II, respectively. Concentric LVH (CLVH) prevalence was 12,3 % higher in WAH individuals than in AH patients (χ2=7,9; p=0,05). Type I diastolic dysfunction (DD) was registered in 87,3 % and 62,1 % of the patients from Groups I and II, respectively. DD prevalence was 25,2 % higher in WAH subjects than in AH participants (χ2=28,5; p=0,001). In Groups land II, increased thickness of common carotid artery wall was observed in 47,2 % and 34,1 %, respectively; its prevalence was 13,1 % higher in WAH patients comparing to people with AH.Conclusion. In WAH and AH patients, DD and LVH were the most typical manifestations of TV damage. DD was more prevalent in WAH than in AH. LVH prevalence was similar in both groups, but CLVH was more typical for WAH than for AH. The same tendency was observed for BC atherosclerosis