Patients with diabetes mellitus are characterized by a higher risk of developing atherothrombotic events than patients without diabetes. One of the reasons for this is the high reactivity and rate of platelet metabolism. The role of aspirin in the prevention of cardiovascular events in patients with diabetes without a history of atherothrombotic events is unclear. In patients with a history of thromboischemic events, aspirin is useful for cardiovascular prophylaxis. Available data suggest that patients with diabetes and acute coronary syndrome (ACS) will benefit more from using more aggressive antiplatelet drugs than clopidogrel (in addition to aspirin), which will reduce the ischemic risk for patients with diabetes of equal or greater degree compared with patients without diabetes. These drugs include ticagrelor (in patients with ACS, regardless of the initial treatment strategy) and prasugrel (in patients with an invasive treatment strategy). For patients with diabetes, high ischemic and low hemorrhagic risks, prolonging double antiplatelet therapy for more than a year with a reduced dose of ticagrelor (60 mg twice a day) can be accompanied by a decrease in ischemic risk.

The review article discusses the use of antihypertensive therapy in patients with arterial hypertension and atherosclerosis of the lower limb arteries from the perspective of current clinical guidelines. Outlined the goal of therapy, rational combination of drugs. The problems and limitations in the appointment of antihypertensive therapy to patients with peripheral arterial diseases in actual clinical practice are discussed. The postulated priority of fixed combinations in the treatment of patients with arterial hypertension and peripheral atherosclerosis to increase adherence to prescribed therapy and improve the prognosis. literature sources from open databases PubMed, MEDLINE, eLibrary are used.

Purpose. To evaluate the efficacy of moxonidine, an imidazoline receptor agonist, in patients with arterial hypertension (AH) and metabolic syndrome compared to enalapril, an ACE inhibitor. Materials and methods. The complex study included 50 patients with AH and metabolic syndrome. Inclusion criteria were abdominal obesity (waist-to-hip ratio (WHR) exceeded 0.95 in men and exceeded 0.80 in women, with BMI ≥25 kg/m², AH of 1st - 2-nd degrees, type 2 diabetes mellitus (DM) in the stage of compensation, dyslipidemia. The mean age of patients was 52 years, duration of AH is 11 years, duration of type 2 DM is 7 years. After examination under conditions of a pure background and obtaining of DM compensation, all patients with AH and metabolic syndrome were randomized into 2 groups. The first group of patients (25 people) received moxonidine, an imidazoline receptor agonist, in individually selected dose of 0.2-0.6 mg per day, an average daily dose of 0.4 mg in twice a day form. The second group (25 people) took enalapril, an ACE inhibitor, in a dose of 5-15 mg per day, an average dose of 10 mg, respectively. A control study was performed after 4 weeks. Results. In patients with AH and metabolic syndrome, the use of moxonidine and enalapril for the correction of blood pressure (BP) showed a comparable effect in changes of office BP, average 24-hour BP, average day-time and night-time BP with the same frequency of achieving target BP. However, only moxonidine showed additional positive effect on the increased BP variability, contributed to the normalization of 24-hour BP profile, reducing the morning rise in BP, reduced the frequency of heart rate and the value of the double product. Moreover, moxonidine had cerebroprotective effects, increasing the cerebrovascular reactivity index. Conclusion. In hypertensive patients with metabolic syndrome, moxonidine provides the best prevention of cardiovascular complications.

The article deals with changes in arterial rigidity in patients with bronchial asthma, depending on the presence of concomitant hypertension. The aim was to study the arterial rigidity parameters in patients with bronchial asthma depending on the presence of arterial hypertension on the standard antiinflammatory therapy for early diagnosis of complications of the cardiovascular system. A significant increase of arterial rigidity was shown, manifested by an increase in the pulse wave velocity in the aorta (AoPWV) and augmentation index (Alx) in patients with bronchial asthma of moderate and severe course in comparison with the control. In the study of the main indicators of arterial rigidity, depending on the presence or absence of hypertension, it was shown that in the group of patients with hypertension, changes in AoPWV and IA were more significant than in the group of patients with normal blood pressure. Increasing of BMI contributes to the development of arterial rigidity in patients with bronchial asthma. The formation of arterial rigidity is associated with clinical and functional parameters and hypoxemia

This review was described in detail the mechanisms of endothelial dysfunction development in patients with essential hypertension, lists the risk factors leading to endothelial dysfunction, diagnostic markers of endothelial dysfunction, and gives an idea of endothelial progenitor cells that can regenerate damaged endothelium. The data of the authors’ own studies were presented evaluating the severity of endothelial dysfunction with the help of such markers as sPECAM-1. The authors were conducted studies of endothelial progenitor cells in patients with different stages and degrees of arterial hypertension.

1409 people (901 Shors, 508 non-indigenous people) from remote villages of Mountain Shoriya (Orton and Ust-Kabyrsa) and urban-type settlement Sheregesh took part in the survey. In Shors, the risk of developing hypertension was determined by elevated levels of total cholesterol and low density lipoprotein cholesterol, violation of carbohydrate metabolism, obesity, including its abdominal type, the family anamnesis of early cardiovascular diseases, and a carriage of prognostically unfavorable genotypes D/D and C/C of the corresponding genes ACE and AGTR 1 candidates; in the cohort of non-indigenous ethnos-elevated levels of total cholesterol and triglycerides, obesity, abdominal obesity, the family anamnesis of early cardiovascular diseases, a carrier of the minor genotype C/C of the AGTR 1 gene

The purpose of this study was to compare the clinical status, miocardial morphofunctional parameters and adherence to treatment on the background of optimal drug therapy (ODT, including agents improve the prognosis and percutaneous coronary intervention (PCf) in combination with ODT in patients with stable coronary artery disease in combination with hypertension grade 1-2 during prospective observation. The study included 125 men aged 50-75 years. The main group (PCf with ODT) included 78 patients aged 61.5 ± 8.5 years; the comparison group (ODT includes 47 patients aged 63.5 ± 7.1 years. Patients did not significantly differ in age and frequency of major cardiovascular risk factors. Both groups’ patients also did not significantly differ in the angina functional class, of ischemic and hypertensive history duration, myocardial infarct frequency and HF functional class. After a year of observation, there were no significant differences in myocardium morphometric and functional parameters in both groups patients against the background of the treatment. 64 (51.2 %) patients, 42 in the main group and 22 in the comparison group, remained fully adherent to treatment. Greatest commitment found in patients younger than 60 years. The main reason of low adherence was a lack of understanding of the need medication taking with good health and normal blood pressure (BP)