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A relationship between erythrocyte Na+/Li(+)-countertransport activity and blood pressure was studied in a randomly selected sample (95 subjects) with full range of blood pressure, from a representative group of inhabitants of one of Moscow's districts. The mean rate of erythrocyte Na+/Li(+)- countertransport activity was higher (p < 0.01 or less) in the groups of subjects with both borderline (BH) and moderate essential hypertension (EH) as compared with the group of normotensives (NT). A positive correlation was found between the erythrocyte Na+/Li(+)- countertransport rate and age and body weight in the entire selected group. The total contribution of these confounding parameters is responsible for 20.4% of the interindividual variability of the Na+/Li(+)- countertransport activity. The individual Na+/Li(+)- countertransport values remained unchanged during at least 2 years of follow-up. A nonlinear relationship between erythrocyte Na+/Li(+)- countertransport activity and blood pressure was established in the entire group. No significant association between blood pressure and Na+/Li(+)- countertransport was seen at high and low values of these two parameters. A pronounced change in the erythrocyte Na+/Li(+)- countertransport values occurred within a narrow borderline blood pressure range.

A study was made of the relationship between Na-Li countertransport and arterial blood pressure in 95 persons selected at random from the representative sample (n = 1716) of the population of one of the districts of Moscow. Of these, 34 persons turned out to be normotensive, 15 had borderline hypertension, 44 stable essential hypertension, and 2 persons presented with secondary hypertension. A positive correlation was found between countertransport and age and weight, determining 20.4% of interindividual variability of countertransport values. The mean value of countertransport in the hypertension group appeared much higher than in the normotensive group, both without and with regard to the correlating parameters. Repeated examinations demonstrated that the countertransport value in each person remained unchanged for two years. A nonlinear correlation was discovered between countertransport and arterial blood pressure. The rate of countertransport is not related to arterial blood pressure (low and high values). A dramatic change in the countertransport values occurred within a narrow borderline range of arterial blood pressure.

Relationships between the prevalence of electrocardiographic high-amplitude R and S waves, the stroke index, mean hemodynamic arterial BP and left-ventricular myocardial thickness (MT) were examined in a population of 411 individuals, aged 35-64 years. The prevalence of those waves is shown to have independent functional relationships with the stroke index and mean hemodynamic BP, irrespective of left-ventricular myocardial morphology. This functional approach is used to explain the causes of low sensitivity of electrocardiographic signs of left-ventricular myocardial hypertrophy when used for diagnostic purposes at population screenings.

A study was made of the peculiarities of the cerebral circulation with regard to the central hemodynamics in 326 men and 410 women aged 20 to 54 with normal and raised arterial pressure (AP) by the methods of bipolar rheoencephalography and tetrapolar chest rheography. In the groups with raised AP men (women) demonstrated a decrease in the blood pulse inflow in the cerebral arteries up to 57% (36%), in the stroke volume cerebral fraction up to 69% (53%), an increase in the vascular tone up to 137% (161%), an increase in the total blood-filling up to 157% (176%), inhibition of the rate of the maximum blood-filling up to 54% (37%) as compared to that in normal. With the transition of an AP borderline level to arterial hypertension the frequency and intensity of rheoencephalographic pathology was on an increase.

The article reflects the results of five-year secondary and primary prevention of arterial hypertension among the workers of a large automobile plant. Secondary prevention of arterial hypertension is an important means of reducing arterial hypertension complications and mortality (the overall mortality went down by 20%, and brain stroke morbidity was 70% lower in the intervention population than in the comparison one). Besides, the search and implementation of the methods of primary prevention of arterial hypertension constitutes the main perspective of the scientific and practical solution of the problem on the population level, as non-drug intervention normalized arterial blood pressure in 70% of subjects with mild hypertension. Thus, arterial hypertension is a complex medico-social problem, the solution of which depends on the fulfillment of equally important medical and socio-cultural tasks.

A representative sample of the population of one Moscow district (people aged 35-64) was studied. All the examined subjects were asked, how often they used alcohol. Only 31.1% of women and 14.3% of men used no alcohol at all. The highest was the percentage of persons using alcohol several times a year: 42.1% of men and 60% of women. Men using alcohol several times a week proved to have arterial hypertension more often than those not using alcohol. Among men aged 55-64 using alcohol several times a week nobody had normal blood pressure. The more alcohol people used, the less they cared for their health and the more rarely they visited a doctor.

One hundred fifty eight patients with essential hypertension (both in- and out-patients) at stages IIA and IIB were treated with diuretics: furosemide (120 mg/day) during three days followed by hydrochlorothiazide in the doses that allow maintaining the renal sodium and water transport of the changed level. Criteria developed for prognosis of the efficiency of diuretic therapy according to the degree of reduction of the mean BP and plasma renin activity after 3-day furosemide intake; indications were worked out for a simultaneous prescription of the potassium-sparing drug amiloride. A good hypotensive effect was noted (reduction of the mean BP by 10 mm Hg) during the first month of treatment in 60 and 70% of in-patients, and in 22 and 40% out-patients with IIB and IIA stages of the disease, respectively. During 6 months of prolonged treatment with diuretics (1-2 years) the sensitivity of the patients to the therapy was increased that permitted the dose of hydrochlorothiazide to be reduced to 25 mg a day or every other day. Patients with good hypotensive effect of therapy were noted to have less pronounced degree of activation of the renin-angiotensin-aldosterone system, than that in patients with ineffective treatment.

Cerebral circulation in relation to central hemodynamics was examined by means of rheoencephalography and chest rheography in 667 individuals with normal and elevated arterial blood pressure. Cardio-cerebral mechanisms are shown to be pathogenetically engaged since early stages of arterial hypertension. They are manifested as decreased cerebral stroke volume, smaller pulse inflow to cerebral arteries and increased vascular tonicity. Cerebral circulatory disorders grew more severe as the disease progressed.

A new approach to the assessment of physiological standards involving the specification in health of three groups of parameters, namely constant, variant and unique is described. A statistical analysis of variant parameters is to be conducted considering their division into types (strata) which are normally characterized by the typical mean values. It is recommended that in carrying out programmes of the prevention of cardiovascular diseases, the susceptibility of different physiological types to the development of corresponding diseases be identified and taken into account.

For successful control over the arterial hypertension among mass populationit is necessary to create the information system of automated register. In practice, its realization is possible on the basis of different polyclinical departments: prephysician examination, fluorography, and physician cabinets. A micro-computer installed in the polyclinic would be purposeful (and real) for operative decision of the automatic register's problems.

Questionnaire survey of 934 residents of various regions of the European part of the USSR and the results of the experimental impact of health education media under polyclinical conditions showed that awareness of alcohol-related risk could be achieved only due to doctor's assistance.

A total of 569 subjects (91.2% response rate) were examined from a 5% random sample of 40 to 64 year-old men and women in the framework of a prophylactic program on hypertension control. There are 181 patients (31.8%) suffering from arterial hypertension (blood pressure 160/95 mm Hg and above). In 111 of them cardiac insufficiency was diagnosed by standard clinical methods and in 60 patients by bicycle spiroergometry. Two-stage bicycle spiroergometry has some advantages over one-stage test: work load volume, physical adaptation coefficient, time of heart rate recovery were increased by 202.7%, 124.4% and 220%, respectively, the exercise tolerance being improved. Cardiac insufficiency was found in 35.3% of cases, latent IA stage, diagnosed by bicycle spiroergometry, being revealed in 18.3%, IB stage in 10.0%, IIA stage in 3.4% and IIB in 3.6% of cases.

The study of an organized population has revealed three types of gustatory sensitivity to sodium chloride: low, medium and high. A certain dependence of salt sensitivity threshold on sex and age has been found. The examination of hypertensive patients in hospitals has revealed that patients with low gustatory sensitivity to salt are characterized by sodium and water retention. High gustatory sensitivity suggests sodium deficiency and corresponds to salt appetite. High salt sensitivity threshold may serve an indication for the administration of diuretics and for dietary salt restriction necessary for hypertension prevention and treatment.

In the cross-sectional population study of 411 subjects aged 35-64 years and longitudinal 5.5-year follow-up of 157 aged 20-54 years, a relationship was examined between pulse blood flow to the cerebral vessels, their tone as assessed by rheoencephalography and resistance to arterial hypertension, coronary heart disease, and brain vascular lesions. The proportion of healthy persons (without the above-mentioned diseases) was shown to be larger if the pulse blood flow to the cerebral vessels was higher and their tone was lower. In the longitudinal study, the probability to remain healthy was demonstrated to be increased with elevated pulse flow to the cerebral vessels.

Hemodynamic values were studied by rheography and tachooscillography in 114 healthy individuals whose ages ranged from 15 to 34 years. According to the cardiac index value, all individuals examined were divided into 3 groups: with hyperkinetic type hemodynamics (cardiac index 5.67--4.32 l/min/m2 in males and 6.06--4.70 l/min/m2 in females), eukinetic (4.31--2,96 and 4.69--3.33 l/min/m2, respectively), and hypokinetic (2.95--1,59 and 3.32--1.95 l/min/m2, respectively). The first type was encountered in 23.7% of cases, the second in 46.5%, and the third in 29.8%. The information yielded by the study is used as evidence in favour of the assumption concerning the heterogeneous character of the hemodynamic norm among the healthy population. It is suggested that the criterion of the initial hemodynamic heterogeneity of the human population is employed in the analysis of the heterogeneity of hemodynamics in individuals with arterial hypertension.

The authors describe a method for evaluating arterial hypertension control among the unorganized population visiting polyclinics and organized population taken care of at the medical centers. The method was tried in the city of Chelyabinsk as applicable to a randomized population sample of a medical territorial district and to a randomized sample (8%) of the workers from 9 shops of the steel plant. The method lies in the study of the population health status (arterial hypertension prevalence and knowledge, treatment coverage and efficacy) and of the documentation available at the treatment and prophylactic institutions concerning arterial hypertension control (coverage, registration, scope of examinations, and so forth). It is shown that the method is unsophisticated and feasible for examination of the population and documentation requires 5 days. It is suggested that the method should be used in the study of the situation concerning arterial hypertension control as well as in the study of the problems in the control of other non-infectious diseases.

By using tetrapolar impedance cardiography and tachooscillography some central hemodynamic indices were studied in 200 healthy males and females, aged 15-49 years, in 40 males with borderline blood pressure, aged 35-49 years, in 50 males with labile arterial hypertension, aged 35-49 years. The central hemodynamic heterogeneity associated with age, sex and different variants of normal blood circulation was revealed in healthy subjects. While comparing the same circulation variants in healthy subjects and in those with borderline blood pressure and labile arterial hypertension, simultaneous increase in a number of subjects with hyperkinetic and hypokinetic variants and intensification of their hemodynamic "vividness" in the groups of patients with elevated blood pressure compared to the group with normal blood pressure were revealed.

Questionnaires were used to examine the extent of hypertensive patients' knowledge of the measures needed to prevent crises and complications of essential hypertension (EH), attitudes to physicians' prescriptions and recommendations and certain elements of hygienic behavior. Male EH patients below 40-50 years of age were found to follow the "I-know-it-is-needed-but-don't-do-it" principle with respect to their health. Many of the older men and the majority of women with EH demonstrated a different health credo: "It is needed, so I am doing it", or "It is needed, so I am trying to do it". Young and middle-aged male hypertensive patients were shown to require medical education to be of convincing or, at some points, even threatening modality, with short and clear-cut health recommendations, while hypertensive females and older males would benefit more from explanatory aids with detailed recommendations on diets, exercise, daily routines, etc.

A three-percent random sample (1267 persons) of the unorganized population of one of the administrative districts of Moscow was examined. Arterial hypertension (AH) was diagnosed in 38.5 percent of the examinees of both sexes aged 35 to 64 years. 65.9 percent of men and 80.9 percent of women were fully aware of being affected with AH. However, only 10.1 percent had received efficient treatment. According to the Rose questionnaire angina pectoris of effort was discovered in 9.6 percent of the examinees. In all 25.8 percent of cases and 30 percent of disability days fell to the lot of essential hypertension and coronary heart disease. The repeated issue of sick-leaves (from 2 to 6 times a year) due to essential hypertension was recorded in 33.8 percent of cases which indicates the lack of regular treatment and control on the part of the treating physician. The sick-leaves were found to be closed irregularly but with the definite intervals, primarily on the 7th, 14th, 21st and 30th days of disability. If hypotensive treatment was given routinely, the mean duration of disability per one patient was two times shorter as compared to that in patients who did not receive any regular treatment.