Resolution of advisory board on issues in the diagnosis of asthma and COPD: current challenges and modern approaches to their resolution

Diagnosis of asthma and chronic obstructive pulmonary disease (COPD) remains an actual problem in Russia. The lack of diagnostics and control of these diseases leads to serious consequences for public health and economic damage. Effective initiatives to improve the level of diagnosis and control of asthma and COPD include the organization of educational activities, instrumental methods of examination, the use of mobile offices for outreach work in remote communities and the introduction of medical information systems. The introduction of digital technologies into medical practice will help to improve the quality of medical care, increase the efficiency of medical centers, and ensure timely diagnosis and control of respiratory diseases. The introduction of modern approaches and methods in the diagnosis of asthma and COPD, active use of validated questionnaires and medical information systems will improve the quality of life of patients and reduce the risks of complications and exacerbations of diseases

Blood pressure control and vascular protection with a fixed-dose combination of lisinopril + amlodipine + rosuvastatin in hypertensive patients

Aim: Assessment of the possibility of the fixed-dose combination of lisinopril + amlodipine + rosuvastatin (Equamer) to achieve further angioprotection in patients with arterial hypertension and high pulse wave velocity (PWV) despite the previous combination antihypertensive therapy (AHT).Methods: The 24-week open-label multi-center observational study involved 60 patients who received dual combination AHT for 6 months. All patients underwent 24 h blood pressure (BP) monitoring, applanation tonometry (determination of the augmentation index and central BP), measurement of the pulse wave velocity and laboratory tests [blood lipids, fasting glucose test, homeostasis model assessment of insulin resistance (HOMA-IR), leptin, ultra-sensitive C-reactive protein (us-CRP)] before and after switching to the fixed-dose combination of lisinopril + amlodipine + rosuvastatin (Equamer).Results: According to the office BP measurements, switching the patients from the dual combinations to the fixed-dose combination of lisinopril + amlodipine + rosuvastatin has resulted in a further decrease of 14.3% in systolic BP (SBP) and 18.5% in diastolic BP (DBP). According to the 24 h BP monitoring data, the SBP has decreased by 16.1% and the DBP by 21.8%. The combination of lisinopril + amlodipine + rosuvastatin has reduced the SBP by 14.4%, the augmentation index by 14.5% and the central SBP by 8.1% (P < 0.01 vs. baseline). The fixed-dose combination of lisinopril + amlodipine + rosuvastatin has provided a 44%-decrease in low-density lipoproteins, a 36.1%-decrease in triglycerids and a 10.3%-increase in high-density lipoproteins (P < 0.01 vs. baseline). The use of the fixed-dose combination of lisinopril + amlodipine + rosuvastatin has provided a definite decrease in the insulin resistance, as well as levels of us-CRP and leptin.Conclusions: The fixed-dose combination of lisinopril + amlodipine + rosuvastatin provides improved BP control, better vessel elasticity indicators (augmentation index, PWV, central BP), boosts the lipid and carbohydrate metabolism and helps to reduce the inflammation and leptin resistance in patients who initially received a dual combination AHT

ACTIV SARS-CoV-2 registry (Analysis of Chronic Non-infectious Diseases Dynamics After COVID-19 Infection in Adult Patients). Assessment of impact of combined original comorbid diseases in patients with COVID-19 on the prognosis

Aim. Study the impact of various combinations of comorbid original diseases in patients infected with COVID-19 later on the disease progression and outcomes of the new coronavirus infection.&#x0D; Materials and methods. The ACTIV registry was created on the Eurasian Association of Therapists initiative. 5,808 patients have been included in the registry: men and women with COVID-19 treated at hospital or at home. ClinicalTrials.gov ID NCT04492384.&#x0D; Results. Most patients with COVID-19 have original comorbid diseases (oCDs). Polymorbidity assessed by way of simple counting of oCDs is an independent factor in negative outcomes of COVID-19. Search for most frequent combinations of 2, 3 and 4 oCDs has revealed absolute domination of cardiovascular diseases (all possible variants). The most unfavorable combination of 2 oCDs includes atrial hypertension (AH) and chronic heart failure (CHF). The most unfavorable combination of 3 oCDs includes AH, coronary heart disease (CHD) and CHF; the worst combination of 4 oCDs includes AH, CHD, CHF and diabetes mellitus. Such combinations increased the risk of lethal outcomes 3.963, 4.082 and 4.215 times respectively.&#x0D; Conclusion. Polymorbidity determined by way of simple counting of diseases may be estimated as a factor in the lethal outcome risk in the acute phase of COVID-19 in real practice. Most frequent combinations of 2, 3 and 4 diseases in patients with COVID-19 primarily include cardiovascular diseases (AH, CHD and CHF), diabetes mellitus and obesity. Combinations of such diseases increase the COVID-19 lethal outcome risk.</jats:p