Search

To compare the effect of 12 months of treatment with moxonidine or bisoprolol on telomerase activity (TA) and parameters characterizing the arterial wall state in postmenopausal women with arterial hypertension (AH) and osteopenia. An open-label randomized study with 114 postmenopausal women with hypertension and osteopenia; pulse wave velocity (PWV), intima-media thickness (IMT), and TA were analyzed initially and after 12 months of therapy with moxonidine (n = 57) or bisoprolol (n = 57). Both medications effectively lowered blood pressure (BP) in both groups. After 12 months, the moxonidine group showed a significant increase in TA by 45.5% (from 0.87 to 1.15; p

A novel coronavirus infection SARS-CoV-2 (COVID19) is especially dangerous for elderly and senile patients. Preventive measures for elderly people should cover three areas: 1) direct prevention of the viral infection, 2) preservation of the functional status and prevention of geriatric syndromes, including the use of social support measures, 3) control of comorbidities. The clinical pattern of COVID-19 in older patients may be atypical, while the mildness of symptoms (no fever, cough, shortness of breath) may not correspond to the severity of the prognosis. Delirium may be the first manifestation of COVID-19, which requires special care in its screening. Management of elderly and senile patients with COVID19 should include measures for delirium prevention, the detection and improvement of nutrition. The risk of malnutrition with sarcopenia increases with hospitalization of a patient, especially when using artificial ventilation, is associated with an unfavorable prognosis during hospitalization, accelerates the progression of senile asthenia and reduces the quality of life. Geriatric assessment is the cornerstone of determining the management of an elderly patient.

Objective: To assess the effect of moxonidine on bone metabolism and bone mineral density (BMD) in postmenopausal patients with arterial hypertension (AH) and osteopenia. Materials and methods: A randomized, open, clinical trial included 114 postmenopausal patients with AH. All participants were evaluated bone metabolism), BMD, telomerase activity (TA). Randomization was carried out into 2 groups (moxonidine and bisoprolol therapy) using simple envelopes. After 12 months of therapy, a dynamic examination was performed. Results: Both groups showed a positive effect of both moxonidine and bisoprolol on hypertension during treatment both as monotherapy and in the group of patients receiving combined antihypertensive therapy: a decrease in SBP and DBP in the 1st group was 13.6% and 12.8% respectively, and in the 2nd group - 13.7% and 15% respectively, while achieving normal values. In most patients of group 1, normalization of body weight was noted in comparison with group 2 (23.4% and 17.4%, respectively, p = 0.043), delta of body weight in the moxonidine group was -1.89%. The increase in the processes of bone formation in the form of increased markers of OC and Osteoprotegerin and a statistically significant increase in TA in patients receiving moxonidine were revealed, while in women who took bisoprolol there were no dynamic changes in bone metabolism rates, there was a tendency for a decrease in BMD and a significant decrease in AT. Conclusions: The detected pleiotropic effect of moxonidine on bone metabolism and replicative cell aging processes will reduce the risk of development or progression of osteopenia and osteoporosis in postmenopausal women with AH.

Aim. To investigate on the presence and relation characteristics of glycemia variability (GV) and vascular wall parameters, chronic inflammation, oxidation status, telomere biology in type 2 diabetes patients (DM2). Material and methods . Into the single-movement study, 50 DM2 patients included, with no signs of cardiovascular diseases. All participants were evaluated on the carbohydrate metabolism, glycemia variablity, underwent duplex scan of carotid arteries with intima-media complex (IMC) measurement, and assessment for atherosclerotic plaques; underwent carotid-femoral pulse wave velocity measurement, endothelium dependent vasodialtion, telomere length measurement and telomerase activity (TA). Results. The parameters of vessel wall, together with the classical CVD risk factors, independently related with the various carbohydrate metabolism parameters: glycated hemoglobin, fasting glucose plasma, HOMA-IR index, C-peptide, immune reactive insulin. The GV of moderate amplitude of glycemia (MAGE) was related to IMC increase in DM2 patients. There was significant relation of telomere length (TL) not just with a chronic hyperglycemia, but with glucose level fluctuations as well, e.g. with GV standard deviation (SD), MAGE, CONGA (continuous overall net glycemic action), and such relation is higher in the analysis of “the longest” telomeres. Relation of TL and GV is not dependent on the cardiovascular risk factors, chronic inflammation and TA, but depends on fasting plasma glucose. There was no significant relation of TA with GV in DM2. There was direct correlation of GV CONGA and oxidative stress marker malonic dialdehyde, and independent negative correlation of GV (MAGE, SD, CONGA) with TL. Conclusion. GV is related with subclinical atherosclerosis (IMC) and shorter TL in DM2 patients, which is mediated by activated oxidation stress under glycemia fluctuations.

Background Despite the growing interest to the theme, the gut microbiota (GM) composition and functional capacity in relation to cardiovascular diseases (CVD) have been poorly studied. It is not well studied in nonagenarians or centenarians who live much longer than others with postponed CVD. In this study, we assessed GM in association with different metabolic factors in healthy middle-aged adults and the elderly at the turn of a hundred years old. Purpose Our aim was to study GM in a healthy cohort (HC) with different metabolic risk factors and in an extremely elderly cohort (EC) of long livers from our city. Methods The study included HC of 104 untreated subjects aged from 25–76y (52±13) carefully selected through the exclusion of CVD and other chronic diseases by means of clinical (with different specialists consultations to exclude any factors of inflammation) and a wide range of laboratory evaluation, ECG, treadmill test, ECHOCG, carotid artery ultrasound and the second group of 20 long livers 97–100y (98±1). EC underwent a complex geriatric assessment, also a wide range of laboratory evaluation, ECG, ECHOCG, carotid artery ultrasound. GM composition was studied by the V3-V4 16S rRNA sequencing. Taxonomic units were identified with QIIME 1.9.1. Statistical analysis was done by using the Phyton v.3.2 programming language. Metabolic reconstruction was performed with PICRUSt algorithm. All GM analyzes performed with age, sex and FDR adjustments. Results One of the most pronounced differences in GM between groups was a significantly higher representation of antiinflammatory Bifidobacterium genus in long livers (p=0.026 (MaAsLin), LDA=4.304). Among risk factors, high body mass index (BMI) was associated with a high abundance of conditional pathogens of Prevotella genus in HC (p Butyrate synthesis potential in EC vs HC Conclusions The EC were unexpectedly healthy. Considering the GM analysis, we may propose that EC microbiota protected long livers from the low-grade inflammation and thus protected them from the development of metabolic disorders by producing a high amount of butyrate, one of the most important anti-inflammatory agents in the human body. Conditional pathogens (the inflammation initiators) associated with BMI and IMT as well as butyrate producers may subsequently become a target for cardiovascular prevention. Acknowledgement/Funding Governmental support

Effective control of arterial pressure (AP) is achieved only in ⅓ of patients with arterial hypertension. It is especially difficult to achieve control of systolic (S) AP in elderly patients in whom SAP is the strongest prognostic factor of cardiovascular complications. Thiazide and thiazide-like diuretics and calcium antagonists are effective for lowering of elevated SAP and pulse (P) AP including aortic PAP elevation of which is associated with high stiffness of arterial wall and is typical for elderly people. Combination of a thiazide diuretic and a calcium antagonist has been recommended by modern guidelines on arterial hypertension (AH) management but until recently it has not found wide application because of absence of a fixed preparation. Evidence base of indapamide-retard and amlodipine use in AH, their profiles of efficacy and safety are such that their combination can become an alternative variant for treatment of patients with AH. Appearance of a fixed indapamide-retard/amlodipine combination opens new perspectives of effective therapy of AH with high SAP and PAP in elderly and other patients with high stiffness of arterial wall.

Insulin resistance plays the main role in the pathogenesis of diabetes mellitus and its complications. It is also a major factor of the pathology associated with age, which leads to accelerated aging. Data about the role of insulin resistance and its correction in vascular aging are presented.

Introduction: Type 2 diabetes mellitus (T2DM) contribute to vascular aging. The telomere length (TL) and telomerase activity (TA) are considered as biomarkers of cellular aging. TL and TA are insufficiently studied in diabetic patients. Hypothesis: Telomere biology is associated with vascular aging in diabetic patients. Methods: The study group included 50 patients with T2DM (mean age 58.4±7.83 years) and 139 healthy patients (mean age 57.45±8.14 years). All subjects were measured for TL and TA by quantitative polymerase chain reaction; oxidative stress marked by malondialdehyde (MDA); inflammation marked by C-reactive protein (CRP); arterial stiffness evaluated by pulse wave velocity (PWV); carotid intima-media thickness (IMT), plaque presence (PP) and endothelial dysfunction evaluated by flow-mediated endothelium-dependent vasodilation (FMV). Results: All patients were divided into 4 groups by the median of TL (9.75): «short» telomeres (T2DM+ (n=15) and T2DM- (n=63) and «long» telomeres (T2DM+ (n=35) and T2DM- (n=76)). Patients with T2DM and «long» TL had the state of vessels, oxidative stress, inflammation, TA as similar as in healthy people: PWV 11.54±3.57 (T2DM+) vs 10.98±1.83 m/s (T2DM-) ((=0.58), IMT 0.83±0.13 vs 0.76±0.16 mm (=0.13), PP 1.36±0.33 vs 1.23±0.20 (=0.79); MDA 2.81±0.78 vs 3.24±0.78 mkmol/l (=0.08); CRP 3.59±0.58 vs 3.66±0.50 mg/l (=0.93); TA 0.51±0.09 vs 0.60±0.05 (p=0.36). FMV was higher in diabetic patients: 11.87±3.36 vs 10.18±2.79 % (=0.049). In contrast patients with «short» TL and T2DM had more pronounced vascular aging, inflammation and lower TA than healthy people: PWV 13.48±3.24 vs 11.59±2.03 m/s (=0.003), IMT 0.95±0.17 vs 0.78±0.14 mm ( Conclusion: In patients with short telomeres and T2DM signs of vascular aging, chronic inflammation and cellular aging were more pronounced than in healthy people. In contrast, in patients with long telomeres and T2DM vascular changes, oxidative stress, chronic inflammation and TA were as similar as in healthy people. Perhaps long telomeres protect patients with T2DM from accelerated vascular aging.