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Aim. To study the catestatin plasma level in patients with primary hypertension of different cardiovascular risk and to assess its relationship with heart rate variability (HRV) parameters.Material and methods. One hundred eighty men aged 30-50 years were divided into groups: group 1 (n=28) — hypertensive patients with medium risk of developing cardiovascular complications (CVC), group 2 (n=76) — hypertensive patients with high risk of CVC, group 3 (n=31) — hypertensive patients with very high risk of CVC. The control group consisted of healthy men with normal blood pressure (BP) (n=45). We determined plasma catestatin (ng/ml) and conducted Holter monitoring.Results. A pattern was found to reduce the concentration of catestatin with increasing risk of CVC in hypertensive patients, but there were no significant differences between the studied groups (p>0,05).We determined corrections between catestatin levels and echocardiography thickness of left ventricular posterior wall (r=-0,523; p=0,045) and interventricular septum (r=-0,523, p=0,045) in diastole in group 2; thickness of left ventricular posterior wall (r=0,258; p=0,035) and interventricular septum (r=0,254; p=0,038) in systole in group 3. In patients of group 2, direct correlations of catestatin levels and sympathicotonia LF/HF were revealed during the whole observation period (r=0,301; p=0,019) and during wakefulness (r=0,308; p=0,019); inverse correlations — with parameters of parasympathetic tone: nHF during the whole observation time (r=-0,318; p=0,013) and during wakefulness (r=-0,342; p=0,007), pNN50 in the afternoon (r=-0,270; p=0,037).Conclusion. A decrease in catestatin concentrations in hypertensive patients is associated with the progression of disease and an increase in cardiovascular risk. It is assumed that catestatin is involved in the formation of HRV in patients with primary hypertension.

Patients with atrial fibrillation have a high risk of developing stroke and death, which requires constant anticoagulant support. In this regard, the physician faces the difficult task of selecting the appropriate oral anticoagulant for patient with individual risk factors and comorbidities. Currently, three non-vitamin K antagonist oral anticoagulants or directly acting oral anticoagulants have been registered in the Russia, which in large randomized clinical trials (RCTs) were compared with warfarin in the prevention of stroke and systemic embolism. The present article analyzes the data of RCTs, postmarketing studies of oral anticoagulants, and presents groups of patients for whom these drugs are preferred. The choice of oral anticoagulants for the prevention of stroke in the following subgroups of patients with atrial fibrillation is discussed: patients with one stroke risk factor (CHA2DS2VASc1 in men or 2 in women), patients of different age groups, patients with concomitant coronary artery disease/acute coronary syndrome, a history of stroke, patients with chronic kidney disease, patients with a high risk of gastrointestinal bleeding, and a group of patients with concomitant arterial hypertension and chronic heart failure. We compared the efficacy and safety of oral non-vitamin K antagonist oral anticoagulants or directly acting oral anticoagulants with vitamin K antagonists in patients with non-valvular atrial fibrillation.

Review of the key studies on antihypertensive, vasodilatatory, angiogenic and antiapoptotic action of catestatin — a peptide resulting from endogenic protease interaction with chromogranin А. Plasma levels of catestatin correlate negatively with the hypertension phenotype. Pathogenetic role is discussed for catestatin in development of essential hypertension and its possible influence as a marker of cardiovascular risk stratification.