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The article reports results of clinical studies aimed to elucidate the influence of medicines on the size and density of atherosclerotic plaques in the walls of coronary and cerebral arteries. The phenomenon of regression of atherosclerotic lesions in the survivors of Leningrad siege during a long period of starvation is analyzed. The influence of inhibitors of angiotensin-converting enzyme on apoptosis of smooth muscle and foam cells of atherosclerotic plaques in the sanological mechanisms of atherosclerosis is discussed. The concept of natural regression of atherosclerosis is formulated and the necessity of development of the methods for is pharmacological activation are formulated.

A review of documents on the peculiarities of obstetric and gynecological care in besieged Leningrad is presented with special reference to the data about the number of children born during blockade and their health status in the first months of life, the work of maternity hospitals, their number and personnel. The term «military time amenorrhea» coined during blockade is discussed.

The article presents information on the history of the Naval Medical Academy (NMA), the preconditions of its creation, the composition of the faculty of Naval Department of the 1st Leningrad Medical Institute, of the 3rd Leningrad medical Institute andfirst teachers of NMA.

A case of congenital cardiac disorder with multiple defects in the secondary interventricular septum and atrial septum aneurysm in a young serviceman is reported. Plastic surgery of the atrial septum with a good clinical outcome included closure of the defect with a flap harvested from the autopericardium under conditions of artificial blood circulation and warm blood cardioplegia.

Arterial hypertension (AH) is a major challenge facing modern medicine. High frequency of AH patients with excess body mass and disturbances ofcarbohydrate metabolism is attributable to their common pathophysiological mechanisms underlain by insulin resistance and resulting compensatory hyperinsulinemia. The authors review modern concepts of AH development in patients with insulin resistance associated with enhanced blood insulin level and increased production of catecholamines playing an important role in AH pathogenesis mediated through sympathetic stimulation of heart, vessels while kidneys. Insulin resistance contributes to AH largely by activating sympathoadrenal system while increased glomerular filtration of glucose is accompanied by its back absorption together with sodium in proximal tubules. It results in hypervolemia and enhanced content of sodium and calcium in vascular walls which leads to their spasm and a rise in the total peripheral vascular tension (TP VT). Insulin promotes fibroblast proliferation and vascular smooth muscle cells via stimulation of tissue growth factors and collagen synthesis in atherosclerotic plaques. The concomitant narrowing of the vessels further increases TPVT. It in turn decreases renal blood flow and thereby activates renin-angiotensin-aldosterone system and development of AH.

The treatment of patients with neuroendocrine tumours and hormonally active distant metastases traditionally included surgical removal of the primary neoplasm, embolization of metastases in the liver, therapy with somatostatin analogs and interferon-alpha to prevent excessive production of regulatory peptides (carcinoid and other endocrine syndromes). Patients with neuroendocrine pancreatic tumours were also treated with alkylating chemotherapeutic drugs including streptosocin and temozolomide. The results of such treatment are far from being satisfactory. Recent progress in the treatment of such patients is due to radiotherapy using somatostatin analogs. Moreover, large-scale randomized studies demonstrated the effectiveness of targeted preparations acting on receptors of vascular growth factors and ripamycin target inhibitors ofmammals. Results of the studies on comparative effectiveness of targeted drugs for combined therapy of neuroendocrine tumours are presented.

Aim: To study peculiar features of daily AP rhythm and profile in men with cardiovascular risk factors residing in the Far North., Materials and Methods: The study included 115 servicemen divided into 3 groups (hypertensive disease (HD), hypertonic type neurocirculatory asthenia (NCA) and risk factor of cardiovascular diseases other than AH). HD was diagnosed based on multiple AP measurements and 24-hr monitoring., Results: HD was associated with elevated mean AP, load indices and AP variability All patients had pathological type of morning dynamics. Normal daily rhythm of systolic AP (SAP) was documented in 66.1% of the patients with HD and in 68% with cardiovascular risk factors without AH. Normal daily rhythm ofdiastolic AP (DAP) was recorded in 63.5% of the patients with HD and in 72% with cardiovascular risk factors without AH. In group 2, normal daily rhythms of SAP and DAP were found in 44 and 56% of the cases respectively., Conclusion: Men residing in the Far North under conditions of anomalous photoperiod need medicamentous correction of AP regardless of AH type. Ambulatory BP monitoring should be preferred for the assessment of the efficacy of antihypertensive therapy.

Atherosclerosis and coronary heart disease are the main causes of disablement and mortality in most developed countries. Clinical studies showed the relationship between coronary calcinosis and atherosclerotic lesions, the calcinosis area accounting for roughly 1/5 of the atherosclerotic plaque area. Calcinosis is quantitatively characterized by the calcium score determined by multispiral and electron-beam computed tomography. High calcium score suggests an increased risk of cardiovascular complications. Their treatment awaits further assessment since a number of studies revealed differential effect of various medicines on coronary calcification.

We analysed the results of the treatment of 4205 patients with different forms of vertebrogenic radiculopathy. They suggest the efficacy of differential application of graduated medicamental therapy, reflexo- and physiotherapy depending on the period of clinical course of the disease.

Morphological criteria for malignant pheochromocytoma remain to be developed According to the WHO recommendations, the sole absolute criteria is the presence of metastases in the organs normally containing no chromaffin tissue. Such signs as cellular and nuclear polymorphism, mytotic activity, vascular invasion, capsular ingrowth are not sufficient to describe a pheochromocytoma as malignant. It is equally dfficult to differentiate between malignant and benign tumours based on histological data since histologically mature neoplasms can produce metastases. Based on the results of original studies, the authors believe that such histological features as vascular and capsular invasion do not necessarily suggest unfavourable prognosis. Therefore, the conclusion of malignancy based on such features can not be regarded as absolute. Probably such neoplasms should be called "pheochromocytomas with morphological signs of malignant growths". They should be referred to the tumours with uncertain malignancy potential based on the known discrepancy between morphological structure and biological activity of neoplasms. Comparative studies of clinical and morphological features of pheochromocytomas showed that their histological type (alveolar; solid, dyscomplexed, trabecular) and morphological signs of malignant growth influence both the clinical picture and arterial hypertension. There are no significant relationship between the above morphological signs, timour mass and clinical manifestations of pheochromocytomas.

Part 1 of this review is devoted to the history of development of temporary and continuous electric stimulation (ES) of the heart. Up-to-date concepts of bradyarrhythmia are considered along with the most important techniques for its management with the use of two-chamber and frequency-adaptive systems. Algorithms for the choice of optimal ES regimes taking account of the type of bradyarrhythmia are discussed. Current concepts of physiological ES of the heart are considered. The authors describe their own experience with the application of ES of the heart.

A rise in the incidence of latent and late forms of neuro- and visceral syphilis significantly complicates diagnostics of the disease in patients admitted to emergency medicine clinics. Syphilis is believed to be a cause of roughly 0.5% of all cardiopathies. Late syphilitic lesions of the cardiovascular system (cardiovascular syphilis) occur in 0.25-0.96% patients in need of therapeutic treatment, 93.4% of them present with mesaortitis but its life-time diagnosis is possible only in 10% of the cases. Syphilitic lesions in the aorta are especially well apparent at the points of its branching into coronary arteries of the heart and aortic arch. One of the main consequences of syphilitic aortitis is the narrowing of coronary arteries frequently complicated by atherosclerosis, coronary thrombosis, and the resulting myocardial infarction. Another severe complication of syphilitic aortitis is progressive aortic valve insufficiency (in 25-50% of the patients) related to dilatation of the valve ring affected by inflammation. Some patients develop bacterial endocarditis of the aortic valve. Close localization of the coronary artery junction and the aortic valve account for a combination of aortic valve insufficiency and coronary insufficiency in patients with syphilitic process in the initial part of aorta. A case report is presented.

To improve differential diagnostics and treatment of coronary heart diseases (CHD) and concomitant climacteric cardiopathy (CCP), we analysed results of clinical examination and laboratory-instrumental studies of 1063 women complaining of chest pain. They were divided in 3 groups: group 1 (817 patients with CHD), group 2 (134 patients with CCP), group 3 (122 patients with CHD+CCP). Peculiarities of laboratory and instrumental diagnostics are described in conjunction with comparative characteristic of multispiral CT coronarography and corononaroangiography.

The authors attribute survival of certain residents of blockaded Leningrad under conditions ofcomplete starvation to activation of natural sanologic mechanisms of the body. Physiological psychoemotional stress is supposed to contribute to the formation of prerequisites for survival during subsequent starvation. Also, the survival is believed to be related to selected activation of apoptosis of renewable cells and utilization of their constituents in endogenous nutrition. The role of priority energetic and trophic support of brain and kidneys and the contribution of the psychosomatic factor are postulated. The mechanisms of rehabilitation after upset of vital activity involve partial reversibility of atrophic and metabolic processes and neural regulation of organs and their systems. The importance of the study of activation of natural sanologic mechanisms in extreme conditions is discussed

A total of 4141 patients complaining of chest pain were divided into 7 groups. They were examined for the analysis of heart pain, cardiac rhythm disturbances, and chronic heart failure. Peculiarities of stable angina of effort in aged and elderly patients are described

The aim of the study was to compare the influence of hypothiazide and indapamide on platelet aggregation in patients with arterial hypertension (AH) and abdominal obesity (AO). 28 and 31 patients were given hypothiazide and indapamide respectively for 16 weeks. The following parameters were estimated: blood lipid spectrum lipid peroxidation in plasma and platelets, platelet aggregation. The data obtained were treated using Student's t-test. Hypothiazide was shown to have beneficial effect on peroxidation syndrome and optimize platelet aggregation. These effects were further promoted by long-term indapamide therapy. Hypothiazide had no effect on the above parameters. It is concluded that a combination of indapamide with non-medicamental factors is needed to reduce body weight in patients with AH and AO.

The study included 1418 patients with FC I-IV stable angina of effort (42.4% men and 57.6% women, mean age 74.6 +/- 1.2 years). The possibility to supplement standard therapy with myocardial cytoprotectors (trimetasidin, mexidol, qudesan) was estimated in 4 groups of patients from the severity of pain syndrome, chronic cardiac insufficiency, and heart rhythm disturbances.

The study was designed to evaluate effect of trandolapril, an ACE inhibitor, on platelet aggregation in patients with arterial hypertension and impaired glucose tolerance. The drug was given to 38 patients for 12 weeks. The key end points were dynamics of the blood lipid spectrum, lipid peroxidation in plasma and platelets, antioxidative protection of the blood's liquid medium and platelets, platelet aggregation. The data obtained were treated using Student's t-test. They show that trandolapril exerts positive effect on peroxidation syndrome and reduces platelet aggregation.

The aim of the study was to elucidate normalizing effect of candesartan on disturbed thrombocytic hemostasis in patients with arterial hypertension and metabolic syndrome. The drug was given for 16 weeks to 31 patients in whom dynamics of lipid peroxidation in plasma and platelets, the antioxidative potential of candesartan, and parameters of thrombocytic hemostasis were assessed. Treatment with candesartan improved lipid peroxidation and primary hemostasis. It is expected that continuation of therapy following this scheme can stabilize the obtained effect.

Arterial hypertension (AH) remains a topical problem in modern cardiology. It increases the risk of angina, myocardial infarction, stroke, neurologic and psychic disorders. Causes, symptoms, criteria and method for the correction of AH in patients with metabolic syndrome are extensively investigated. However, disturbances of hemostasis and approaches to their efficacious correction in such patients remains unexplored.

A group of 830 patients with spondylogenic visceropathies was divided into three with clinical symptoms of bronchial (n = 80), cardiac (n = 530), and abdominal (n = 220) vertebral syndromes. Their clinical features, differential diagnosis and methods of treatment are described.

The aim of the study was to assess effects of irbesartan on disturbed platelet hemostasis in patients with arterial hypertension and metabolic syndrome. 38 patients received this drug for 16 weeks. Dynamics of lipid peroxidation in plasma and platelets, antioxidative protection of liquid blood fraction and platelets were estimated. The data were treated by the Student's t-test. Therapy with irbesartan for 4 months improved lipid peroxidation and primary hemostasis. Its continuation following the same regimen is expected to strengthen the obtained effect.

Under the term amyloidosis is meant a group of diseases with a variety of clinical symptoms characterized by extracellular deposition of insoluble pathologic fibrillar proteins in tissues and organs. A report is presented of a 93-year-old patient admitted to a multifield hospital for the treatment of cerebral vascular disorders and peripheral nervous disturbances; the patient developed signs of myocardial infarction recognized in clinical/instrumental studies and died. Primary amyloidosis with diffuse vascular lesions in internal organs was diagnosed at autopsy. The death was caused by marked dystrophic changes in myocardium, liver and kidneys, hepatic and renal insufficiency.

Gastrointestinal stromal tumours (GIST) first described in 1983 are the commonest mesenchymal neoplsams of the digestive tract. The main pathogenetic mechanism is hypersecretion of tyrosin kinase receptor c-kit (CD-117) by GIST cells and its hyperactivation. A rare clinical case of GIST measuring 1.2 CM with concomitant stomach cancer (poorly differentiated carcinoma) is reported. The tumours were discovered intraoperatively. To our knowledge, data on such cases are practically lacking in the literature.

An original method of proximal gastrectomy was used to eliminate hemorrhage from gastric and oesophagal varicose veins in 27 patients with portal hypertension. The follow up period varied from 1 to 23 years. The risk of hemorrhage and the degree of vein dilatation were assessed by endoscopy and endoscopic ultrasonography. It is concluded that the method used in the study may be recommended as the first-line surgery for the management of hemorrhage from gastric and oesophagal varicose veins with good functional results in the late postoperative period and rare complications.

Coronary artery bypass grafting (CABG) is traditionally considered to be the "golden standards" of treatment for patients with the affected trunk of left coronary artery (LCA) due to its good early and late outcome, low mortality rate and frequency of repeat surgery. This fact is well documented as reflected in relevant guidelines of European and American scientific societies. However, the recent years have witnessed markedly extended application of drug-coated stents despite the fact that immediate and delayed results of such treatment need more comprehensive verification. This review is focused on the evaluation of advisability of using drug-coated stents to manage lesioned LCA based on the results of randomized studies in comparison with CABG and percutaneous transluminal coronary angioplasty. An optimal method for the treatment of the affected LCA trunk is proposed based on the available data. It is concluded that CABG remains the method of choice for the treatment of this pathology (in the absence of contraindications) ensuring good early and late outcome, low mortality rate and necessity of repeat surgery.

The review is focused on atrial fibrillation soon after coronary artery bypass grafting. The most popular algorithms for the prevention and management of this condition are discussed including the protocol accepted in the Cardiosurgical Centre of P. V. Martynov 2nd Central Military Hospital. Modern concepts of pharmacotherapy of atrial fibrillation, restoration, and maintenance of sinus rhythm are considered.

Diagnosis of acute coronary syndrome (ACS) in elder patients encounters difficulty due to age-specific features of CHD resulting from a number of physiological and pathological changes associated with aging. This study was designed to analyse the structure of risk factors and clinical signs of ACS based on the examination of 176 patients of different age groups. It turned out that the number of risk factors and concomitant disorders grows with age. The occurrence and significance of certain risk factors (smoking, obesity) tends to change in the opposite direction. Old and very old patients show increased frequency of subtle and atypical forms of ACS. This together with variable ECG features on tribute to the difficulty of diagnosis.

The aim of the study was comparative analysis of long-term results (5 years) after coronary angioplasty and stenting (CAS) and coronary artery bypass grafting (CABG). The results of the treatment of 1100 patients with coronary heart disease, operated since 1999 to 2006 year, were analyzed. 720 (65.5%) patients had undergone CABG (group 1), 226 (20.5%) had had an implantation of stents with pharmaceutical coverage (group 2) 154 (14%) had been implanted with stents without pharmaceutical coverage (group 3). Clinical examination as a rule had occurred before operation, 29-30 days after operation and in every 12 months after discharge from the hospital. Five years survival rate in group of CABG patients was 85.9% and in groups of CAS patients it was 84.1% and 70.8% respectively. Restenosis occurred more frequently in CAS patients: in group 2 in 18.1% patients, in group 3--in 70.1% In group of CABG patients acute myocardial infarction occurred in 11.9% cases to the end of 5th year, in groups 2 and 3 this index was 10.9% and 18.3% respectively. Angina pectoris was absent in 1 year in CABG patients (62%) than in CAS patients (46.7% and 24.3% in groups 2 and 3 respectively; p < 0.05). Comparing results of CAS with use of stents with and without pharmaceutical coverage, the best clinical result was in the group with implanted stents of new generation. Relatively better clinical effect during 5 years occurred in CABG patients.

The influence of angiotensin II blocker in thrombocytes aggregative capacity in patients with arterial hypertension and metabolic syndrome was assessed. 32 patients were treated with eprosartan during 16 weeks. Dynamics of lipid peroxidation in plasma and thrombocytes, liquid part of blood and platelets antioxidant immunity, thrombocytes aggregative capacity were assessed. The results were processed using Student's test. The use of eprosartan in patients with arterial hypertension and metabolic syndrome has positive influence on peroxidation syndrome and optimizes thrombocytes aggregation.

Coronary artery disease (CAD) remains the leading cause of death in most highly developed countries. According to the WHO, more than 17 million people in the world die of cardiovascular pathology (CVP) annually; of them, more than seven million die of CAD. For the medical service of Russian Federation Armed Forces, CAD and atherosclerosis present an important problem due to their prevalence in military men leading to high levels of morbidity, mortality, labor losses, disability, dismiss rate and disqualification of highly professional officers and generals. Certain factors of military service and extreme factors have been found to increase CAD risk. Until now, the incidence and prevalence of initial forms of CAD in military men of dangerous professions have been studied insufficiently. In order to investigate the prevalence of atherosclerotic cardiosclerosis (ASCS), the effects of risk factors (RF), and prognostication of its development, 267 military men, including 14 men of dangerous professions (pilots, navigators, command post operators), and 153 engineers, technicians and supply officers were examined at Military Hospital No7, Mandryk Military Hospital No 2, and four units of a Space Forces division. The clinico-functional examination revealed ASCS in 53 or 19.8% of the servicemen; its rate increased with age. Only a few cases of ASCS were found in subjects aged less than 30 years; a significant increase in ASCS frequency was noted in 41- to 50-year-old subjects (29.8%); between 51 and 60 years old ASCS was found in 32% of the subjects, which meant only a 2.2% increase vs. the previous age group. Possibly, this could be connected with the fact that at this age initial signs of initial forms of CAD, including ASCS in military men of dangerous professions depended not only on age, conventional RF of CAD, but on occupational hazardous factors as well. Lipid exchange disorder is an important RF for the development and progress of various CVP, CAD in the first place. Timely and correct diagnostics and interpretation of an altered lipid profile as well as assessment of concomitant cardiovascular RF are necessary conditions to organize rational prophylaxis of the most important CVP.

Experience of 10-years observation of 164 patients who underwent radiation impact, 38 (23%) afterwards had chronic obstructive pulmonary disease (COPD), is analyzed in the article. It is demonstrated, that timely COPD diagnostics must be based on thorough gathering of anamnestic data, analysis of clinical manifestations and results of annual examination of pulmonary ventilation function. Changes in time of COPD clinical symptoms among COPD patients who underwent radiation influence are considered. It was established, that in patients who underwent radiation influence, COPD began in younger age, coursed more severe, with more frequent aggravations, requiring inpatient treatment. Therapy of this category of persons required all drugs used at COPD treatment.

The aim of the study was to evaluate therapeutic effects of losartan on intravascular thrombocyte activity (ITA) in patients suffering from arterial hypertension with metabolic syndrome (MS). The subjects of the study were 35 patients administered losartan 50 mg a day for 4 months. The dynamics of the following parameters were evaluated: anthropometric parameters, blood lipids, lipid peroxidation in blood plasma and thrombocytes, the anti-oxidative protection of the liquid part of blood and platelets, and ITA. Student criterion was used for statistical analysis. In patients with AH and MS losartan had a positive effect on peroxidation syndrome and optimized ITA. To maintain the positive effects, prolonged administration of losartan is needed. In order to lower body mass in AH patients with MS losartan should be used in combination with non-drug means.

In patients with arterial hypertension (AH) accompanied by abdominal obesity (AO) increase in platelets adhesive and aggregation functions was noted in vitro and in vivo. The cause of these disturbances is blood serum and platelets lipid peroxidation activation, increase in synthesis of Willebrand's factor in a vascular wall, and intensification of thromboxane production in platelets. Activation of thromboplastin production is the main cause of increase in blood coagulation in patients with AH and AO.

Many-year observation of patients with arterial hypertension revealed that late diagnosis of the initial stage of the disease was typical. Time elapsed from the first medical record of an arterial pressure (AP) of higher than 140/90 mmHg to the moment the diagnosis of arterial hypertension was made was 4.5 +/- 1.6 years in 16 out of the 198 subjects. The authors offer new criteria for the diagnosis of boundary arterial hypertension based on 24-hour AP monitoring (unfavorable type of 24-hour AP profile) and veloergometry (hypertensive response to physical load). Active screening for boundary arterial hypertension based on instrumental examination is recommended, and an algorithm for its search is offered.

The purpose of the study was to compare the influence of two ACE inhibitors--captopril, a sulfhydryl one, and fozinopril, a phosphate one--on the aggregation activity of thrombocytes in patients suffering from arterial hypertension (AH) with metabolic syndrome (MS). Sixty-nine patients suffering from AH with MS were examined; 36 patients were administered captopril during 16 weeks, while 33 patients were treated with fozinopril during the same period of time. Changes in anthropometric parameters, blood lipid spectrum, lipid peroxidation in blood plasma and thrombocytes, and the antioxidative protection of liquid part of blood and platelets, as well as the aggregation activity of thrombocytes were assessed. The data received were processed using Student criterion and system multifactor analysis. The study shows that the use of fozinopril in patients with AH and metabolic syndrome attenuates peroxidation syndrome and optimizes thrombocyte aggregation. Prolonged fozinopril application will stabilize the achieved effect. Captopril did not have a positive effect on the parameters under study. In conclusion, fozinopril should be applied in combination with non-drug means to lower body weight in patients suffering from AH with MS.

The purpose of the study was to compare long-term results of angioplasty and coronary arterial stenting (CAS) depending on the initial degree of coronary arterial (CA) lesion according to morphological stenosis classification, as well as to evaluate the influence of re-stenosis on myocardial contractility dynamics, anginal recurrence rate, and exercise tolerance. The subjects, 228 men after angioplasty and 184 men after CAS with wire stents without drug coating, were included in the study between 1989 and 2005. Coronarography was repeated in 358 patients one year after surgery. The patients were divided into two groups. The first group consisted of 161 patients, to who 180 stents were implanted. The second group consisted of 197patients, in who 226 angioplasty procedures were performed. Data were processed using standard variational statistical methods, i.e. the calculation of mean values and standard deviation. Statistical calculations were carried out using Analysis ToolPak- VBA software of Microsoft Excel 2000. The study found that one year after either intervention the number of patients without anginal symptoms fell significantly compared with this number during the in-hospital period. In group 2 the frequency of restenosis was higher and the number of patients with anginal symptoms was significantly bigger than in group 1; the number of asymptomatic patients was significantly bigger in group 1. Initial morphological characteristics of CA lesion had a significant effect on the long-term frequency of restenosis following endovascular treatment. Restenosis was 2 to 2.5 times more frequent in patients with C type CA lesion vs. patients with A type regardless the method of endovascular intervention. The results of the study demonstrate the importance of taking into account initial morphological characteristics of CA lesion; CAS is more preferable than angioplasty, especially in patients with C type CA lesion.

Neuroendocrine tumor consisting of pancreatic alpha-cells -- glucagonoma -- is a very rare finding (one case per two million people a year). This functionally active, usually malignant tumor has typical clinical manifestations. Glucagonoma syndrome is a disease that has an original clinical picture that includes necrolytic migrating erythema with secondary bullous dermatitis, glucose tolerance disorder or diabetes mellitus, weight loss, anemia, hypoaminoacidemia, venous thrombosis, and alimentary and mental disturbances. By the time diagnosis is made, 60 to 70% of glucagonomas already give metastases, and even small glucagonomas should be considered tumors with unknown malignant potential or malignant tumors. Glucagonomas grow slowly, and patients live long (the survival median is approximately 15 years). The authors describe their own observation.

The course of arterial hypertension (AH) was evaluated retrospectively in 306 patients, who had undergone annual hospital examination and treatment during the previous five years. After five years, AH had got complicated with ischemic cerebral stroke (ICS) in 147 patients (group 1). AH had not got complicated with ICS in 149 patients (group 2). These patients had been observed for another five years. By the end of the study, 98 patients had remained in group 1, and 100 patients had remained in group 2. Mean term of observation had been 10.3 +/- 0.8 years in group 1, and 10.1 +/- 0.9 years in group 2. Clinico-anamnestic analysis revealed the following peculiarities of the course of AH complicated by ICS: a longer AH course before the development of ICS; faster deterioration of AH in a period of 10 years; faster deterioration of chronic cardiac insufficiency and discirculatory encephalopathy; more frequent combination with coronary heart disease and carbohydrate exchange; more frequent development of transitory ischemic attacks (TIA); TIA became more frequent before the development of ICS; in 70% of group 1 patients TIA was located in the place of a future ICS. The authors suggest that slowly and quickly progressing AH forms should be differentiated according to the progression of the risk of cardiovascular complications.

The subjects of the study were patients suffering from arterial hypertension with metabolic syndrome; the study found that thrombocyte aggregation function was intensified, while the antiaggregation activity of the vascular wall was weakened in these patients. The mentioned changes are underlied by deep alterations in lipid exchange, the activation of serum lipid peroxidation, and disturbances in the synthesis of prostacycline in the vascular wall, associated with the intensification of thromboxane formation in the platelets.

The degree of cardiac insufficiency, which to a large extent is determined by changes in the volume and geometric characteristics of the left ventricle (LV), is an important prognostic factor of survival of patients after myocardial infarction. The term "postinfarction LV remodeling" was introduced to describe processes that lead to its dysfunction. This process becomes most important when postinfarction LV aneurysm (LVA) is formed. Recent research into the role of LV structure and mechanics show the hemodynamic significance of postinfarction LVA, especially in cases of its substantial expansion onto the interventricular septum (IVS). That is why a clear concept of the hemodynamic significance of postinfarction LVA and the extent of IVS involvement in a case with a prominent disorder of stereometric characteristics is a key factor for both choice of the optimal tactics and prediction of the end result of treatment of this threatening complication of coronary heart disease.

Wartime arterial hypertension (AH) is AH that debuts or changes its character under the influence of specific wartime factors or military labor. The features of wartime AH were determined. They included the following: AH incidence during war grows; AH incidence in the battlefront servicemen is higher than in those who serve on the home front; there is a direct correlation between AH prevalence and how often the person participates in the battles; the patients are relatively young. Acute AH forms usually debuted as a result of extremely strong of lingering stressful factors. Acute AH development was characteristic of subjects having family predisposition to hypertensive reactions. The clinical picture of acute AH had features of a hypertensive crisis, frequent complications of which were acute cardiac insufficiency and/or acute hypertensive encephalopathy, which required urgent medical aid. AH was resistant to pharmacotherapy. Further on, high AH level remained, crises occurred, and lesions of target organs progressed. The features of AH in military operators were characterized by medium, high, and very high risk of complications. II and III degrees of AH prevailed. The main risk factors in patients with workplace arterial hypertension (WAH), in addition to emotional tension, often were smoking, family background, hyperlipidemia, excessive body weight (metabolic syndrome). In 87% of patients with WPAH behavioral type A was revealed, mostly with medium or prominent elevation of the level of personal, reactive, and total anxiety. Persons with prognostically unfavorable 24-hour profiles of BP--non-dippers and night-peakers--prevailed (p < 0.001). Imidazoline receptor agonists (moxonidine) in patients with WAH normalized BP level. Twenty-four-hour BP profiles became normal in 90% of the WAP patients. Positive antihypertensive effects of moxonidine in patients with WAP become clear after 12 weeks of drug application; the psychological status becomes normal too.