Regular aerobic exercise is recommended for the prevention and complex treatment of patients with hypertension. Increasing public awareness about modifiable risk factors and the introduction of various tools to help patients to improve these factors is one of the priority goals of modern healthcare. Regular physical activity lowers total blood cholesterol levels. ‘The Moscow longevity’ program helps patients of retirement age to increase their daily physical activity, to improve their mood, overall well-being and prognosis.

The frequency of arterial hypertension has a clear tendency to increase with age. The presence of obesity imposes additional difficulties on the choice of antihypertensive therapy regimen due to the variety of pathophysiological mechanisms of raising blood pressure in patients with a combination of hypertension and obesity. This article presents the clinical case of a 68-year-old patient with hypertension and obesity, discusses a comprehensive approach that includes diet, regular physical activity, cognitive training and pharmacotherapy with the fixed combination of amlodipine with telmisartan and the imidazoline receptor agonist moxonidine. The choice of this combination is due to the following reasons: the ultra-prolonged action of both drugs, which allows you to control blood pressure during the day, including in the morning, when there is the greatest number of cardiovascular events; organoprotective properties; improving carbohydrate metabolism; reducing the risk of diabetes; antiatherosclerotic properties. The choice of moxonidine is due to the need of effective control of blood pressure, reduction of the activity of the sympathetic nervous system, because hypersympathicotonia is one of the central pathogenetic mechanisms for raising blood pressure in patients with hypertension and obesity, and the decrease in resting heart rate less than 80 bpm (an independent risk factor for cardiovascular complications in hypertension). Dietary recommendations will help to reduce body weight and blood pressure, slow the progression of atherosclerosis, prevent the development of cardiovascular catastrophes, and improve the quality of life. The aim of physical activity is reducing body weight, improve cognitive functions and reduce cardiovascular risks. Cognitive training will help improve cognitive function and, consequently, increase patient adherence to treatment. After six weeks of complex treatment, the patient noted the achievement of the target blood pressure, weight loss, improved mood, increased exercise tolerance, improved quality of life, as well as a decrease in proteinuria, which completely disappeared after another three months of therapy.

Arterial hypertension (AH) remains one of the most significant medical and social problems in the world, its prevalence among the adult population is 30–45%. Along with this, the modern population is characterized by a high incidence of chronic kidney disease (CKD), including due to their secondary damage in the framework of hypertension. In turn, CKD is an important independent risk factor for the development and progression of cardiovascular diseases, including fatal ones. The use of existing approaches to nephroprotection in the treatment of patients with hypertension will significantly improve the prognosis both in patients with risk factors for developing renal dysfunction and in patients with pre-existing kidney disease. According to current recommendations for hypertension in such clinical situations, therapy should begin with fixed combinations of antihypertensive drugs. The combination of an angiotensin converting enzyme inhibitor (ACE) and a dihydropyridine calcium channel blocker (CCВ) demonstrated the greatest effectiveness according to evidence-based medicine in patients with high-risk hypertension, including from the standpoint of nephroprotection. In the presented clinical case, the successful use of a fixed combination of ACE and CCВ in a patient with hypertension and microalbuminuria is described.

Purpose. To evaluate the accuracy of measuring blood pressure (BP) by the ECG and Medicom-Combi daily blood pressure monitoring system, designed to monitor blood pressure with oscillometric and auscultatory methods, among adults in accordance with the European Hypertension Society’s International Protocol for validation of adult blood pressure measuring instruments (ESH‑2001).

Materials and methods. Patients were recruited based on criteria recommended by the ESH‑2001 protocol. A total of 99 pairs of test and control measurements of blood pressure were obtained (three pairs of measurements for each of 33 subjects). The measurements were carried out sequentially on the same arm. For the arm circumference of 24–32 cm and 32–42 cm, two cuffs of the test complex were used (adult small and adult large, respectively).

Results. When testing the complex, 66, 93, and 99 measurements were obtained within 5, 10, and 15 mmHg for systolic blood pressure (SBP) and 66, 89 and 95 measurements for diastolic blood pressure (DBP), respectively, using the oscillometric method, as well as 71, 93 and 97 measurements for SBP and 71, 84 and 93 measurements for DBP, respectively, when using the auscultatory method. The mean ± SD of the differences between the test and control measurements were 1.8 ± 5.4 / 1.6 ± 6.9 mmHg for SBP / DBP using the oscillometric method and 0.8 ± 5.9 / –1.2 ± 7.9 mmHg for SBP / DBP using the auscultatory method.

Conclusion. The complex of daily monitoring of ECG and blood pressure Medicom-Combi, designed for daily monitoring of blood pressure, meets the requirements stated in the international protocol ESH‑2001 (class ‘Passed’) for adults and is recommended for use in clinical practice.

The annual increase in the incidence of influenza, SARS, and the COVID‑19 pandemic indicate the need for comprehensive programs to support congenital antiviral immunity. To increase the effectiveness of the treatment of viral respiratory infections, it is important to attenuate the effects of the so-called cytokine storm and enhanced compensation of the patient’s comorbid pathologies. Increasing the availability of zinc, vitamin C and rutoside can improve the body’s resistance to viral infections. In addition to micronutrients, to reduce the activity of allergic inflammation, second-generation H1-histamine receptor blockers (loratadine, etc.) and calcium gluconate can be used. To lower the  temperature, it is important to include paracetamol in therapy.

Vitamin A (retinol) is one of the key elements for regulating the immune response and controls the division and differentiation of epithelial cells of the mucous membranes of the bronchopulmonary system, gastrointestinal tract, urinary tract, eyes, etc. Its significance in the context of the COVID‑19 pandemic is difficult to overestimate. However, a number of studies conducted in the past have associated the additional intake of vitamin A with an increased risk of developing cancer, as a result of which vitamin A was practically excluded from therapeutic practice in developed countries. Our review highlights the role of vitamin A in maintaining human health and the latest data on its effect on the development mechanisms of somatic pathology.

Currently, due to the high availability of drugs and the growing volume of the pharmaceutical market, there is a clear trend towards an increase in the number of drug-induced liver injuries (DILI), which can be associated with the use of almost all classes of prescription or non-prescription drugs including herbal remedies, dietary supplements and biological food supplements, etc. Due to the high relevance of this problem, the article is devoted to the epidemiology and classification of DILI, the principles of management of patients with DILI, prognosis and prevention of DILI, taking into account European and Russian clinical recommendations for the management of patients with DILI – European Association for the Study of the Liver (EASL; 2019), Russian Gastroenterological Association (2019), Scientific Society of Gastroenterologists of Russia / Russian Scientific Medical Society of Therapists (NOGR / RNMOT) (2020). The criteria for the diagnosis of DILI are described in detail, a number of classifications of DILI are given (by severity, pathogenetic, clinical and laboratory, by phenotypes and clinical and morphological forms). Risk factors for DILI include age, gender, race, genetic factors, certain concomitant diseases and conditions, polypharmacy, drug-drug interactions, and drug characteristics (dose, duration of administration, lipophilicity, etc.). In the diagnosis of DILI, the central link is the assessment of cause-effect relationships between taking the inducer drug and the development of symptoms of liver damage, for this purpose it is recommended to use the CIOMS-RUCAM scale, and indications for liver biopsy are determined. The diagnosis of exclusion of DILI and its formulation require studies aimed at differentiation with acute viral hepatitis, autoimmune hepatitis, Wilson’s disease, Bad Chiari syndrome, primary biliary cholangitis, primary sclerosing cholangitis, cholelithiasis, and oncological diseases. Variants of the course of DILI with the selection of favorable and unfavorable prognostic signs are considered. The choice of hepatoprotective therapy has been discussed. The data on the possibilities of the drug Heptrong in the treatment of DILI are given. Particular attention is paid to preventive measures that impede the development of DILI.

Introduction. Cytokines regulate intercellular and intersystem interactions and are involved in the development and prevention of various pathologies. Purposes of work were a comparative assessment of the dynamics of the levels of pro- and anti-inflammatory blood cytokines (TNF-α and IL‑10) in patients with community-acquired viral-bacterial pneumonia (CAVBP) with ceftriaxone monotherapy with antibiotic and combined use this antibiotic with the antiviral drug Kagocel, and comparison of getting data with native (reference) indicators of healthy patients.

Materials and methods. The study included 60 patients, aged 18–65 years, with a confirmed diagnosis of community-acquired pneumonia of moderate severity, divided into two groups equal in number, comparable by gender, age and timing of admission to the hospital. The first group received intravenous monotherapy only with the antibacterial drug Ceftriaxone, and the second group received a combination of Ceftriaxone with the oral antiviral drug Kagocel.

Results. A pronounced imbalance of the levels of proand anti-inflammatory cytokines in patients with CAVBP of both groups was demonstrated both during the onset of the disease and on the 7th day hospitalization. When analyzing the concentration ratio of TNF-α / IL‑10, it was found that monotherapy with an antibacterial drug did not lead to a decrease in this indicator, while when using a combination of an antibiotic with an antiviral drug, a significant decrease in its values to normal was observed on the 7th day treatment. Good tolerance of the combination therapy and the absence of adverse reactions were noted.

Conclusion. The addition of Kagocel to the treatment regimen for CAVBP with ceftriaxone contributed to the decrease the concentration of TNF-α and increases the level of IL‑10, which is clinically reflected in a reduction in the duration of fever, symptoms of general intoxication, catarrhal phenomena and the duration of hospitalization (by 1 day) compared with ceftriaxone monotherapy.

The aim of the study was to determine the prognostic criteria for the severity of postinfarction (within 12 months) course in patients of working age who underwent Q-myocardial infarction (Q-MI), having studied the relationship of significant biochemical parameters with hemodynamic parameters and primary endpoints.

Materials and methods. We observed 104 male patients of working age who were admitted to the hospital with primary Q-MI, receiving rosuvastatin at a dose of 40 mg and atorvastatin at a dose of 80 mg as part of complex therapy.

Results. A direct correlation was found between the baseline parameters of C-reactive protein (CRP), aldosterone, creatinine phosphokinase, erythrocyte sedimentation rate, leukocytes, left ventricular myocardial mass (LVMM) and the primary endpoints studied during 12 months of observation in patients of working age who underwent Q-myocardial infarction.

Conclusions. Thus, the baseline level of CRP, aldosterone, creatinine phosphokinase, erythrocyte sedimentation rate, blood leukocytes and LVMM were the prognostic markers of the severity of postinfarction course in patients of working age who underwent Q-MI.

Spectral analysis of heart rate variability gives an idea of the role of the autonomic nervous system in the regulation of chronotropic heart function. This method can be used to evaluate the effectiveness of drug therapy. Drug therapy should be carried out taking into account the individual clinical form of atrial fibrillation. Information about the vegetative status of the patient will undoubtedly increase the effectiveness of treatment. In this study, spectral parameters were studied in patients with newly diagnosed atrial fibrillation. The effect of antiarrhythmic drug class III amiodarone on the spectral parameters of heart rate variability was studied.

The article examines the reasons for restenosis of the Calypso stent with a bioresorbent coating three months after installation by 90–95% on the background of self-withdrawal of atorvastatin and ticagrelor. Recommendations for myocardial revascularization of the European Society of Cardiology and the European Association of Cardiothoracic Surgeons, dual antiplatelet therapy are presented. The problems of stent restenosis associated with various methods of percutaneous coronary intervention are discussed. The data of the Russian register RECORD‑3 on adherence to treatment with statins and antiplatelet agents after percutaneous coronary intervention are presented.