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Aim: To assess the role of obstructive sleep apnea and other cardiovascular (CV) risk factors in the development of the antihypertensive therapy (AHT) efficacy "escape" phenomenon in patients with arterial hypertension (AH)., Materials and Methods: The data of 75 patients with AH stage I-II, grades 1-3 were proceeded. All patients included in the study underwent night respiratory monitoring. After AHT prescription, blood pressure (BP) was monitored by three measurement methods (office, daily monitoring and self-control of blood pressure) - initially, in 1, 3 and 6 months after the inclusion - in order to confirm the initial therapy efficacy and to identify or exclude the "escape" phenomenon., Results: In 36.0% of patients, the "escape" phenomenon was diagnosed in 1 or 3 months of observation. When comparing the group with the "escape" phenomenon, an initially higher level of systolic BP was revealed according to office measurements, 24-hour monitoring and self-control BP monitoring (134.0±4.7 mmHg vs 126.0±8.5 mmHg; 129.0±2.3 mmHg vs 121.0±7.7 mmHg; 131.0±8.2 mmHg vs 121.5±6.2 mmHg resp.; р <0,05). There were no differences in sleep apnea and CV risk factors between the groups. However in patients with a minimal SpO 2 ≤85% during sleep, there were a higher levels of office systolic BP both before the AHT prescription, and during its use (157.6±10.4 mmHg vs 152.4±8.1 mmHg resp., р <0,05; 132.0±6.8 vs 127.1±8.9 mmHg resp.; р <0,05), and mean 24-hour systolic BP (125.7±5.9 vs 121.6±8.2 mmHg resp.; р <0,05) - compared with patients with a minimum SpO 2 >85%., Conclusion: The higher BP level in patients with lover nocturnal hypoxemia does not allow us to exclude the delayed negative impact of obstructive sleep apnea, especially severe, on the BP profile in case of initially successful AH control.

Obesity is an independent predictor of cardiovascular diseases (CVD), including heart failure (HF). Nevertheless, numerous studies have shown that patients with CVD who are overweight and slightly obese have a better short-term and moderate prognosis than thinner patients with CVD. This phenomenon has been called the obesity paradox. Understanding the obesity paradox is important in patients with HF, given the high prevalence of obesity in patients with HF. The article presents an overview of clinical studies devoted to the study of obesity as a risk factor for HF, the pathogenesis of HF in obesity, and highlights the issues of the obesity paradox and the treatment of obesity in this category of patients.

First cases of new coronavirus infection were registered in December 2019. The COVID-19 outbreak was declared a global pandemic. COVID-19 is much more dangerous for people older than 65. It is well known that cardiovascular diseases are more affecting older patients as well. The potentially dangerous combination of the new infection and different cardiovascular diseases has become a crucial problem of cardiology in 2020.

Due to the global aging of the population, the deteriorating ecology and lifestyle changes, patients with isolated cardiovascular diseases (CVD) are becoming less common, and the portrait of a comorbid patient comes first in the structure of patients with CVD. Among a number of diseases complicating and concomitant with cardiovascular, a special place is occupied by chronic obstructive pulmonary disease (COPD). The prevalence of COPD among CVD patients can reach 60%. Many of the pathophysiological mechanisms underlying COPD can increase the risk of cardiovascular disease and vice versa. The most common cases of COPD are arterial hypertension, coronary heart disease, heart failure, and atrial fibrillation. Given the close relationship between COPD and CVD, it is clear that treatment for one condition can affect another. This review discusses current positions about the influence of both groups of diseases on each other, and also observes the effects of drug therapy of both diseases.

Aim: The purpose of this study lied in the examination of the clinical characteristics and assessment of the quality of treatment for patients with arterial hypertension (AH) with obesity according to the National Registry of the AH., Materials and Methods: The frequency of obesity in a sample of patients with AH, observed in 2010-2016. in polyclinics and cardiological dispensaries for cardiovascular diseases (CVD), was 38.3%, of which the incidence of severe obesity (grade III) was 8%. Women account for the majority of obese AH patients (72%)., Results: The study revealed the burden of AH patients with obesity in the following risk factors for CVD: dyslipidemia, hyperglycemia and a history of early cardiovascular disease. Relatively often in patients with hypertension with obesity, there were lesions of target organs (hypertrophy of the left ventricle, chronic kidney disease of the third stage), CVD [ischemic heart disease (CHD), chronic heart failure (CHF) II-IV functional class NYHA] and diabetes mellitus type 2 These data indicate that patients with AH obesity refers to a high and very high cardiovascular risk., Conclusion: Conducted antihypertensive and hypolipidemic therapy (statins) in patients with AH obesity was not optimal, only 30% of patients achieved the target level of BP and 23.6% - the target level of total cholesterol.

Cardiovascular diseases (CVD) and cancers are the leaders in their prevalence and the major causes of death in economically developed countries, determining their high sociomedical significance in society. Improvement of methods for the early diagnosis and treatment of cancers has contributed to increases in relapse-free survival and life expectancy in these patients. At the same time, the new problems have emerged particularly in the development of various cardiovascular events/diseases when treating cancer, which may predict worse prognosis in patients and be an independent cause of death. To search for new markers of cardiotoxicity at early stages and to develop effective methods for the prevention and personalized treatment of cancer and CVD are the problems that can be solved only by joint efforts of cardiologists and oncologists.

We studied prevalence of arterial hypertension (AH) and its association with major cardiovascular (CV) risk factors among unorganized adult population aged 25-64 years in 10 Russian cities (Volgograd, Voronezh, Ivanovo, Irkutsk, Krasnoyarsk, Orenburg, Vladikavkaz, Samara, Tomsk, Tyumen) with different climatic, geographical, economical and demographical characteristics. This cross-sectional epidemiological study was conducted within the framework of the ESSAY RF-2012 (Epidemiology of Cardiovascular diseases in the Regions of the Russian Federation) project. Epidemiological situation concerning AH was found to be unfavorable. Prevalence of CV risk factors was high especially in young men and postmenopausal women. Major CV risk factors, associated with AH were hypertriglyceridemia, hyperglycemia, and obesity. The obtained results substantiate the expediency of the use of population strategy of AH and CV risk factors prevention in the studied population.

Objective: To study an independent role of the obstructive sleep apnea syndrome (OSAS) in patients with arterial hypertension (AH) according to the data of a retrospective observation., Subjects and Methods: all patients underwent polysomnographic test (EMBLA Flaga, Iceland) and the frequency of unfavorable events (stroke, myocardial infarction, chronic heart failure, atrial fibrillation, intermittent claudication, or death) was determined during the case-control observational longitudinal retrospective study. The diagnosis of OSAS was made when the apnea-hypopnea index (AHI) of more than 15 events per hour of sleep; the patients with an AHI of less than 15 formed a control group., Results: Among 120 enrolled patients, 64 (53%) had OSAS. In the patients with OSAS, the baseline AHI was 50.9 +/- 23 events per hour whereas in the control group it was 8.9 +/- 5.2 per hours. Both groups were comparable in age, height, weight, body mass index, snore duration, drowsiness, and respiratory standstill during sleep, blood pressure, total cholesterol, and creatine. While analyzing OSAS, there was no change in the risk for a combined end point (all-cause death, stroke, myocardial infarction, chronic heart failure, atrial fibrillation, or intermittent claudication). Our study was retrospective, the patients were few and AH is itself an important cardiovascular risk factor which should be borne in interpreting the results of our study. We consider that the study of the independent role of OSAS should be continued within a well-designed prospective observation.

Aim: To study effects of body mass loss due to orlistat on carbohydrate and lipid metabolism, insulin resistance, 24-h profile of arterial pressure (AP), left ventricular myocardial hypertrophy, brain perfusion in patients with metabolic syndrome (MS)., Material and Methods: Thirty middle-aged patients with MS entered the trial. They received orlistat in a dose 120 mg twice a day for 24 weeks. Before and after the treatment the patients' carbohydrate and lipid metabolism, insulin resistance were studied, 24-h monitoring of arterial pressure, echo-cardiography were made. Brain perfusion was studied with single-photon emission computed tomography in 18 patients. Results. All the patients lost much weight. This was accompanied with improved indices of AP profile, metabolism of carbohydrates and lipids, insulin resistance, left ventricular hypertrophy, brain perfusion. Conclusion. Orlistat treatment weakens basic factors of cardiovascular risk.

There is a pathogenetic interrelationship between obesity and hypertension. Moreover it has become evident that the use of most modern and active antihypertensive drugs can not be effective without concomitant treatment of obesity. This study was conducted in 18 cities of Russian Federation in order to demonstrate influences of lifestyle changes on hypertension and levels of cardiovascular risk factors. The objective was to attract attention of physicians and patients to the problem of obesity and hypertension and to their inherent dangers.

Aim: To compare brain perfusion in hypertensive patients with diabetes mellitus type 2 (DM2) or metabolic (MS) syndrome and hypertensive patients without clinicobiochemical signs of DM2 or MS; to study enoxaparin effects on brain perfusion in DM2 and arterial hypertension (AH)., Material and Methods: Seventy patients included in the study were divided into three groups: 30 patients with DM2 and AH (group 1), 30 patients with MS and AH (group 2) and 10 AH patients without manifestations of MS or DM2 (group 3). All the patients have undergone single-photon emission computed tomography (SPECT) of the brain, carbohydrate and lipid metabolism were examined., Results: Deterioration of brain perfusion was more prominent in DM2 and MS patients with AH than in hypertensive patients with normal metabolism. Stress test with acetasolamide revealed defective autoregulation of cerebral blood flow in hypertensive patients with DM2. A 6-week therapy with enoxaparin significantly improved brain perfusion in hypertensive patients with DM2., Conclusion: Enoxaparin treatment of hypertensive DM2 and MS patients with abnormal perfusion of the brain can be used for prevention of cerebrovascular complications.