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The authors researched the changes in the prevalence of hypertension and major risk factors (overweight, obesity, smoking and high cholesterol) in men of young age--officers of the Eastern Military District during the five-year dynamic observation (2009-2014). 1043 servicemen were selected for the survey. 96.5% of selected servicemen or 1011 people agreed to take part in the survey, the average age was from 25 to 45 years. It was found that among young men the prevalence of hypertension decreased to 24.4%; this result is lower than in the group of civilian population of the same age. It was also found that commitment to healthy lifestyle has increased and the prevalence of the most common risk factors (overweight and obesity, hypercholesterolemia, smoking, alcohol consumption) has decreased but in comparison with the civil population prevalence of modifiable risk factors remains high. The study showed that during the reform of the Armed Forces of the Russian Federation and the inherent strength of military labour remains high, which can not but affect the health officers, 95.5% identified hypertensive patients in our study, young men 35 years with 1st stage of the disease.

Aim: To assess antihypertensive efficacy of a low-dose combination of amlodipin with lisinopril in the treatment of patients with arterial hypertension (AH) of the second degree., Material and Methods: A total of 42 patients with the second degree of AH (16 males, 26 females, mean age 55-9 +/- 1.9 years) entered an open, comparative and controlled trial. They were divided into three groups by the treatment. Group 1 (n = 14) received amlodipin (normodipin, Gedeon Richter) monotherapy in a mean dose 8.9 +/- 0.6 mg/day, group 2 (n = 12) - lisinopril (diroton, Gedeon Richter) in a mean dose 17.5 +/- 1.4 mg/day, group 3 (n = 16) was given combined therapy with amlodipin+lisinopril in a dose 6.8 +/- 0.7 and 8.7 +/- 0.6 mg/day, respectively. The drugs were given for 12 weeks. The efficacy of the treatment was assessed by the results of 24-h monitoring of blood pressure, echocardiography, endothelium-related vasodilatation of the brachial artery (ERVD), dopplerographic investigation of circulation in the middle cerebral artery (MCA), heart rate and cost-effect estimation., Results: Combined low-dose treatment with amlodipin and lisinopril for 12 weeks allowed achievement of target blood pressure in more patients and lower systolic and diastolic blood pressure than monotherapy with each of the drugs. There was also a positive effect on E/A index, ERVD, MCA circulation., Conclusion: Low-dose combined treatment with lisinopril and amlodipin is more effective and cost-efficient. Moreover, lisinopril addition to amlodipin corrects side effects of amlodipin on central nervous system.

The peculiarities of clinical picture, the course character and outcomes were studied in 804 servicemen suffered from pneumonia aged 18-20. According to the body mass index (BMI) they were divided into two groups. Group I was consisted of 400 patients with extra-hospital pneumonia against the background of body mass deficiency, BMI was less than 19.0. Group II was consisted of 404 servicemen suffered from pneumonia; BMI in this group was more than 19.0. The investigation has shown that body mass deficiency in patients with extra-hospital pneumonia is the independent aggravating factor. The pneumonia is the independent aggravating factor. The pneumonia course in such patients was more severe, with significant involvement of pulmonary tissue, development of different complications and as the result the period of hospital treatment was longer than in those with normal body mass.

We measured the content of NO metabolites in blood plasma and urine and concentration of HSP70 proteins in the plasma and leukocytes from 126 women with normal pregnancy, gestosis, and preclinical gestosis. In women with gestosis accompanied by NO deficiency the concentration of HSP70 proteins in the plasma increased more significantly than in leukocytes. These changes are an important marker of endothelial dysfunction and reflect the severity of cell damage during this disorder. The decrease in excretion of NO in the urine and increase in HSP70 protein content in leukocytes and plasma characterize endothelial dysfunction in women with preclinical gestosis.

Aim: To study endothelium-dependent vasodilatation (EDVD), plasma endothelin 1,2 (ET-1,2) contents and urinary NO metabolites in normal pregnancy and various kinds of gestoses with evaluation of normodipine effects on blood pressure and EDVD., Material and Methods: 59 primigravidas 18-32 years of age (pregnancy terms 34-39 weeks) were divided into three groups. Group 1 consisted of 23 women with arterial hypertension treated with normodipine in 11 of them. In group 2 sixteen pregnant women had edema and group 3 consisted of 20 women with physiological pregnancy. 12 non-pregnant women comprised a control group., Results: In normal pregnancy ET-1,2 content was low while urine NO metabolites levels were high. This contributes to maintaining adequate reaction of the brachial artery in response to the "shiftstress". In women with edema the brachial artery response to short-term occlusion was decreased. In women with both high blood pressure and edema had vascular response paradoxically spastic with a two-fold decrease in blood flow rate, high plasma ET-1.2 contents and low urine NO metabolites levels. Normodipine in gestational arterial hypertension normalizes both blood pressure and EDVD., Conclusion: Endothelial dysfunction is an important factor predisposing to development of arterial hypertension. Monotherapy with normodipine (5 mg/day in a single daily dose) during 3 weeks is effective in controlling gestational hypertension.

Aim: To elucidate effects of sodium ethamsylate (SE) on anticoagulant and antiaggregation activity of vascular endothelium in patients suffering from hemorrhagic fever with renal syndrome (HFRS)., Materials and Methods: A trial of SE enrolled 70 HFRS patients (58 males, 12 females aged under 30 years) compatible by the disease severity. They were divided into two groups. 42 patients of the control group received standard therapy, 28 patients of the study group received adjuvant 12% solution of SE in daily dose 1500-2000 mg in the course of HFRS oliguria period. Hemostatic parameters were measured before and after the cuff test to investigate the condition of vascular wall with calculation of the athrombogenicity index (the ratio of the relevant indices before and after the cuff test). SE effects on vascular endothelium was assessed by a blind method., Results: In oliguria, both groups had baseline antiaggregation indices significantly higher than in the control. After the cuff test, control patients' indices tended to an increase while in the study group there was a marked decrease. The trend in anticoagulant activity of microvascular endothelium did not differ much with the groups. This picture persisted also in polyuria. In convalescence hemostasis was similar in both groups., Conclusion: SE enhances antiaggregant activity of vascular endothelium in oliguria period of HFRS without affecting its anticoagulant properties. This is explained by a direct effect of SE on vascular endothelium.

Aim: To evaluate effect of hemodialysis on functional state of platelet-vascular and red cell components of hemostasis in patients suffering from severe hemorrhagic fever with renal syndrome (SHFRS)., Materials and Methods: Parameters of platelet-vascular and red cell hemostasis were studied in 51 patients with SHFRS who were divided into two groups. 27 patients of group 1 received conservative treatment, 24 patients of group 2 were put on dialysis., Results: In oliguria, red cell deformity, spontaneous and induced aggregation was similar in both groups. There was a statistically significant anemia, platelet hyperreaction., Conclusion: The detected disorders in hemostasis are attributed to severity of the disease but not effects of hemodialysis.

Willebrand's factor (WF), antithrombin III (AT-III), blood 5'-nucleotidase and athrombogenic properties of the vascular wall were studied in the course of the disease in 69 patients suffering from hemorrhagic fever with renal syndrome (HFRS). The patients were chiefly under 27 years, had severe or moderate condition. It was found that WF rose 3-fold in oliguria, but returned to normal values by convalescence. AT-III remained stable. High activity of 5'-nucleotidase reached the pick in oliguria and polyuria. As shown by a cuff test, athrombogenic potential of the vascular wall remained low. A role of vascular endothelial impairment in HFRS is discussed.

The study determined the content of free, total and thrombocytic serotonin in 26 patients suffering from hemorrhagic fever with renal syndrome (HFRS) varying in stage. Oligoanuria and polyuria periods of the disease were associated with a 5.5-fold increase in the level of free serotonin whereas the level of blood platelet serotonin reduced two-fold and more. The convalescence period was characterized by rapid recovery of free serotonin values, thrombocytic serotonin being still insufficient. Peak values of total serotonin were noted in the polyuric period.

Altogether 38 patients (33 men and 5 women) suffering from grave and moderate hemorrhagic fever with nephrotic syndrome (HFNS) were examined. The hemolysate aggregation test and ADP were employed to explore the aggregation ability of platelets in those patients. Besides, measurements were made of the activity of the 3rd platelet factor in the plasma and serotonin content in each platelet. A considerable rise of the aggregation activity of platelets was established to take place in the oligoanuric and polyuric periods of HFNS. At the same time the increase in the blood of the 3rd platelet factor and lowering of serotonin in each platelet were noted. The role of platelet hyperaggregation in the pathogenesis of HFNS is discussed. The conclusion is made that such patients were in a prethrombotic state in the oligoanuric and to a lesser degree in the polyuric periods.

A basal value of antidiuretic activity (ADA) of the plasma was determined in 79 HFRS patients and stimulated activity using the insulin tolerance test in 24 persons. A decrease in the plasma ADA was observed in the acute period of disease. The insulin tolerance test did not cause a statistically significant increment of the plasma ADA in the HFRS patients.

Fifty-six patients with hemorrhagic fever and renal syndrome (mainly with grave and medium-grave disease patterns) were examined for the morphology of red blood cells using scanning electron microscopy. In addition, a study was made of the deformability and aggregation properties of red blood cells. The role of the impaired erythrocytic component of hemostasis in the pathogenesis and clinical picture of hemorrhagic fever and renal syndrome is discussed.