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The aim of the Systolic Blood Pressure Inter-vention Trial (SPRINT) was to evaluate whether setting the therapeutic goal for systolic blood pressure (SBP) at <120 mm Hg could reduce cardiovascular events (CVD) compared to the target <140 mm Hg. The study was promoted and funded by several areas at the US National Institute of Health and the collaboration of the US Veterans Administration. The results showed benefits in the intensive treatment group with a reduction in the incidence of cardiovascular events and mortality that exceeded the increase in adverse events, both in the total population and in the participants with chronic kidney disease. The substudies aimed to left ventricular hypertrophy, low diastolic blood pressure, cognitive impairment, and quality of life showed similar results. Several epidemiological studies showed that 30% of cardiovascular risk occurs in people whose SBP is between 115 and 140 mm Hg. These characteristics influenced the new guide-lines developed by several scientific societies in the USA to modify the classification of blood pressure levels and therapeutic recommenda-tions, generating a controversy that still contin-ues. This review describes some concepts that we consider relevant for the patient’s individual approach, highlighting the need to obtain a) reliable and reproducible measurements of blood pressure and b) improving the care of people who have blood pressure levels indicating increased cardiovascular risk independently of the classifi-cation adopted for blood pressure levels., El Estudio de Intervención sobre la Presión Arterial Sistólica (SPRINT: The Systolic Blood Pressure Intervention Trial) evaluó si el objetivo terapéutico de llevar la presión arterial sistólica (PAS) a <120 mm Hg podría reducir los eventos cardiovasculares (ECV) comparado con el objetivo <140 mm Hg. El estudio estuvo promovido y financiado por varias áreas del Instituto Nacional de la Salud de Estados Unidos y con la colaboración de la Administración de Veteranos de Estados Unidos. Los resultados mostraron beneficios en el grupo con tratamiento intensivo con reducción en la incidencia de eventos cardio-vasculares y mortalidad que excedían el incremento de eventos adversos, tanto en la población total como en los participantes con enfermedad renal crónica. Los subestudios en participantes con hipertrofia ventricular izquierda, diastólicas bajas, deterioro cognitivo y calidad de vida mostraron resultados similares. Varios estudios epidemiológicos muestran que un 30% del riesgo cardiovascular ocurre en personas cuya PAS está entre 115 y 140 mm Hg. Estas características influyeron para que las nuevas guías elaboradas por varias sociedades científicas de Estados Unidos modificaran la clasificación de los niveles de presión arterial y las recomendaciones terapéuticas, generando una controversia que aún continúa. Esta revisión describe algunos conceptos que consideramos relevantes para el enfoque individual del paciente, remarcando la necesidad de obtener: a) registros confiables y reproducibles de la presión arterial y, b) mejorar el cuida-do de las personas que tienen niveles de presión arterial, indicando incremento del riesgo cardio-vascular independientemente de la clasificación adoptada para los niveles de la presión arterial.

Despite the prophylactic medicine achievements through the past decade, tobacco smoking remains one of the main risk factors of appearance and progression of diseases, which are accompanied by the high population mortality.Aim: development of the new approaches of complications prediction, prophylaxis and treatment in patients with high and very high total cardiovascular risk, which are based on the heart rhythm turbulence evaluation.Materials and Methods: 603 patients were chosen for the research. All patients were divided into tree groups. The first – patients with IHD without concomitant risk factors, such as smoking, obesity, metabolic syndrome. The second – patients, who smoke for more than 2 years (people with very high cardiovascular risk by SCORE scale). The third group – patients with metabolic syndrome without IHD or hypertension (patients with high cardiovascular risk). Control group included 149 patients. Holter monitoring of the heart rhythm was performed in patients with high and very high cardiovascular risk by the SCORE scale with myocardial infarction to study the specifications of the heart rhythm turbulence. Plasma calcium and magnesium levels were measured to establish the correlation between appearance and progression of ventricular arrhythmia and increase of the heart rhythm turbulence phenomenon.Results. The prevalence of ventricular and supraventricular arrhythmia is reliably higher among the smokers than among healthy persons. The highest percentage of the ventricular extrasystoles both the early appearing extrasystoles and the group extrasystoles is observed among smokers. Among healthy people every fourth person has deviations in heart rhythm turbulence indices, and every seventeenth has significant deviations and high risk of cardiac sudden death. Smokers have reliable decrease of calcium and increase of magnesium plasma levels. People with heart rhythm turbulence, metabolic syndrome and hypertension have reliable increased in calcium pla

Postoperative arterial fibrillation (AF) is one of the most common complication after cardiac surgery . POAF affect the length of hospital stay, incidence of postoperative stroke and mortality. The main factors of postoperative AF include age, gender, left atrial size, presence of AF before surgery. The most effective drugs to prevent POAF are beta-blockers and amiodarone. In many cases statins, blockers of the renin -angiotensin system are prescribed. Clinical management of patients with POFP and urgency of restoring sinus rhythm are determined by hemodynamic parameters. In unstable hemodynamic condition electrical cardioversion is performed.