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Modern tactics of antihypertensive therapy with fixed dose combination or with free combinations of antihypertensive drugs are reviewed in the article. The evidence that a flexible regimen of combination antihypertensive therapy is more reasonable in the modern treatment of arterial hypertension is presented. The question of the characteristics of hypertensive patients in whom lowering blood pressure to lower target levels may be useful to improve the prognosis is discussed considering the results of the analysis of data on participants in a randomized clinical trial SPRINT. Approaches to reducing the incidence of adverse events caused by antihypertensive therapy in such patients in general and in elderly and senile patients who have not only a higher likelihood of achieving advantages of more intensive antihypertensive therapy regimens for influencing the prognosis, but also a higher risk of complications, due to therapy are considered. The problem of less high efficacy of using replicated antihypertensive drugs (generics) compared to the original drugs is discussed.

A role of angiotensin-converting enzyme (ACE) inhibitors in cardiovascular diseases treatment and prevention is discussed. Some large randomized clinical trials are analyzed. Physical and chemical properties of drugs and its evidence base are considered among possible factors of ACE inhibitors choice. A problem of ACE inhibitor choice is also discussed in context of secondary prevention of cardiovascular complications in arterial hypertension and after myocardial infarction. It is concluded that the choice of any drug for cardiovascular disease treatment is mainly determined by its evidence base.

A role of angiotensin-converting enzyme (ACE) inhibitors in cardiovascular diseases treatment and prevention is discussed. Some large randomized clinical trials are analyzed. Physical and chemical properties of drugs and its evidence base are considered among possible factors of ACE inhibitors choice. A problem of ACE inhibitor choice is also discussed in context of secondary prevention of cardiovascular complications in arterial hypertension and after myocardial infarction. It is concluded that the choice of any drug for cardiovascular disease treatment is mainly determined by its evidence base.

Aim. To study effects of ramipril, molsidomine and their combinations on morphofunctional heart indices and clinical status of patients with chronic heart failure (CHF), which complicated an ischemic heart disease (IHD).Material and methods. 41 patients with CHF class II-III (NYHA), which complicated IHD (postinfarction cardiosclerosis) were included in the study. Patients did not receive ACE inhibitors. Patients were split in 3 groups: patients of the 1st group received ramipril, patients of the 2nd group - molsidomine and patients of the 3rd group – combination of ramipril and molsidomine. Clinical examination, laboratory tests, electrocardiogram, cardiac ultrasonograthy, exercise tolerance test was performed before treatment and after 3 months and 1 year of treatment.Results. Improvement of clinical status and decrease of class NYHA was found in 38,5% of patients in ramipril group; in 33,3% of patients in molsidomine group and in 23,1 % of patients in combined therapy group. Increase of ejection fraction on 17 % from initial level was found in patients receiving combined therapy; on 25,2% - in patients receiving molsidomine; and on 12,4% - in patients receiving ramipril. Decrease of residual volumes of a left ventricle also was detected.Conclusion. All therapies (ramipril, molsidomine and their combination) in patients with CHF class II-III and postinfarction cardiosclerosis are clinically and hemodynamically effective in long term implementation.

Aim. To evaluate antianginal and antiischemic activity of molsidomine (Corvaton) in stable angina pectoris of II-III functional class (FC).Material and methods. 45 patients with II FC (31 persons) and III FC of angina (14 persons) were included into the study. All patients took molsidomine in individual doses during 3 months. Antianginal and antiischemic activity of molsidomine was estimated by veloergometric tests.Results. Molsidomine therapy resulted in disappearance of angina pectoris in 41, 7% of patients with stable angina of II-III FC and reduction of ST depression.Conclusion. Molsidomine is an effective antianginal and antiischemic medicine in patients with stable angina of II-III FC and provides the stable effect during long-term usage.

Aim. To evaluate antianginal and antiischemic activity of molsidomine (Corvaton) in stable angina pectoris of II-III functional class (FC).Material and methods. 45 patients with II FC (31 persons) and III FC of angina (14 persons) were included into the study. All patients took molsidomine in individual doses during 3 months. Antianginal and antiischemic activity of molsidomine was estimated by veloergometric tests.Results. Molsidomine therapy resulted in disappearance of angina pectoris in 41, 7% of patients with stable angina of II-III FC and reduction of ST depression.Conclusion. Molsidomine is an effective antianginal and antiischemic medicine in patients with stable angina of II-III FC and provides the stable effect during long-term usage.

Apixaban is a "new" oral anticoagulant, direct Xa factor inhibitor with a good evidence base of the efficacy in the prevention of ischemic stroke in patients with atrial fibrillation. The article is devoted to apixaban use in clinical practice: examination before apixaban administration, clinical situation when laboratory control and monitoring are needed, drugs interactions (at the level of CYP3A4, P-gp), management of patients with bleeding because of apixaban therapy (including antidotes application), perioperative management of patients receiving apixaban.

Apixaban is a "new" oral anticoagulant, direct Xa factor inhibitor with a good evidence base of the efficacy in the prevention of ischemic stroke in patients with atrial fibrillation. The article is devoted to apixaban use in clinical practice: examination before apixaban administration, clinical situation when laboratory control and monitoring are needed, drugs interactions (at the level of CYP3A4, P-gp), management of patients with bleeding because of apixaban therapy (including antidotes application), perioperative management of patients receiving apixaban.