Abstract Objective To study cerebrovascular autoregulation in pts with arterial hypertension (AH) with orthostatic hypotensive reactions (OHR) during an active orthostatic test (AOT). 50 pts with AH (40 g, 10 m), 68.5±5.3 years, I-III gr. were examined. Blood pressure monitoring (BPM) by “BP Lab”, Russia. AOT was performed with continuous measurement of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the digital artery (“Task Force Monitor”, “CNSystems” Austria). The criteria for the OHR were evaluated according to guidelines ESC, 2018. Cerebral hemodynamics in the middle cerebral artery (MCA) was monitored during the AOT (Angiodin-2K (BIOSS company, Russia), using a transcranial sensor with a freq. of 2 MHz. In the MCA, systolic (Vs), diastolic (Vd), average cerebral blood flow velocity (Vm), pulsation index (Pi), and vascular resistance index (Ri), the difference ΔVm30s,% and ΔVm30s, were recorded. Statistical analysis was performed using the non-parametric Mann-Whitney method using Statistica 6.0 Results In 17 (34%) pts with AH, OHR was detected. BP in pts with OHR compared with pts without OHR (mmHg), SBP: 131.7±12.2 vs 131.3±13.8, p>0.05; DBP 74.3±11.8 vs 75.3±8.9, p>0.05). In AOT in pts with OHR, the Vm in the orthostasis significantly decreased compared to pts without OHR, both in the first 30 s. and at 3 min. (Tabl.1). Conclusions In pts with AH of older age groups with OHR, in comparison with the same category of pts without OHR, there is a change in cerebral autoregulation in the form of a more pronounced decrease in cerebral blood flow velocity in MCA in the orthostatic position. Funding Acknowledgement Type of funding source: None

Objective: To determine the best way for detecting the delayed inefficiency of an antihypertensive therapy (AHT). Design and method: The AHT (2–3 drugs from various 1st line groups) was assigned to 102 hypertensive patients (52 men, age 54.2 ± 9.8 years). Antihypertensive agents and their dosages were selected during 2–3 weeks of ambulatory management, with the possibility of a single correction initially prescribed AHT. In all participants were achieved the target BP levels at the stage of inclusion, which were confirmed by office blood pressure monitoring (OBPM) (<130/80 mmHg, oscillometric method, OMRON, Japan), and by ambulatory blood pressure monitoring (ABPM) (24-hour BP < 130/80 mmHg, oscillometric method, BpLab, Russia). 1 and 3 months after the inclusion stage the evaluation of the efficacy of AHT was carried out by OBPM, ABPM, and by assessment of home blood pressure monitoring (HBPM) data. Results: During the first three months of taking recently prescribed AHT, 34 patients (33.3%) demonstrated the escape phenomenon in according to a data at least of one of the measurement methods. There were identified: 22 cases (64.7%) of the escape phenomenon by OBPM, 28 cases (82.4%) - by HBPM, and 32 cases (94.1%) - by ABPM. The sensitivity and specificity for the OBPM were 46.1% and 93.6% respectively, for the HBPM - 78% and 88% resp., and for the ABPM - 82% and 92% resp. Conclusions: It is recommended to carry out the ABPM, and to assess HBPM data after 1 and 3 months of taking recently prescribed optimal AHT to identify the escape phenomenon, prevent cardiovascular events, and to reduce a number of the repeated hospitalizations.

Objective:to study the relationship between brachial-ankle pulse wave velocity (PWVba) and cardio-ankle vascular index (CAVI) with BMI, waist circumference (WC), hip circumference (HC), ratio of waist circumference to hip (RWH) in young hypertensive patients with abdominal obesity (AO).Design and me

Objective: To detect predictors of the delayed inefficiency of antihypertensive therapy (AHT) among arterial stiffness parameters. Design and method: The AHT (2–3 drugs from various groups) was assigned to 102 hypertensive patients (52 men, 54.2 ± 9.8 years). Antihypertensive agents and their dosages were selected during 2–3 weeks of ambulatory management, with a possible single correction of the initially prescribed AHT. In all participants were achieved the target BP levels at the inclusion stage, which were confirmed by office blood pressure measurement (<130/80 mm Hg, oscillometric method, OMRON, Japan), and by 24-hour ambulatory blood pressure monitoring (mean 24-hour BP < 130/80 mm Hg, oscillometric method, BpLab, Russia). In addition, the applanation tonometry was carried out with carotid-femoral pulse wave velocity (cf-PWV) assessment (SphygmoCor, AtCor Medical, Australia). 1 and 3 months after inclusion stage the evaluation of the efficacy of AHT was carried out by OBPM and ABPM. Results: During the first three months of taking recently prescribed AHT, 34 patients (33.3%) demonstrated the escape phenomenon in according to the data of at least one of the measurement methods. There weren’t differences between two groups (with and without the escape phenomenon) by the classical cardiovascular risk factors. In one-factorial logistic regression models, the next predictors of the escape phenomenon were detected: cf-PWV > 10,8 m/c (OR 2,9, 95% CI 1,24 – 7,17, p = 0,01), 24ASI > 137 (OR 4,9, 95% CI 1,72 – 13,43, p = 0,002), 24PBP > 46 mm Hg (OR 6,3, 95% CI 2,27 – 17,6, p = 0,0003). The maximum sensitivity and specificity for the 24PBP was revealed (81,8% and 58,5% resp., pic. 1).Conclusions: After the AHT administration, in addition to the control BP measurements, it is important to provide the arterial stiffness assessment – to determine the odds ratio of the escape phenomenon.

Objective: To determine the target BP levels, obtained by ambulatory blood pressure monitoring (ABPM), achievement of which will reduce the chances of delayed inefficiency of antihypertensive therapy (AHT) in the next 3 months after its prescription (an escape phenomenon). Design and method: The AHT (2–3 drugs from various groups) was assigned to 102 hypertensive patients (52 men, 54.2 ± 9.8 years). Antihypertensive agents and their dosages were selected during 2–3 weeks of ambulatory management, with a possible one-time correction of the initially prescribed AHT. In all participants at the inclusion stage were achieved the target BP levels, which were confirmed by OBPM (<130/80 mmHg, oscillometric method, OMRON, Japan), and by ABPM (24BP<130/80 mmHg, oscillometric method, BpLab, Russia). 1 and 3 months after inclusion the evaluation of the efficacy of AHT was carried out by OBPM and ABPM. Results: During the first three months of taking recently prescribed AHT, 34 patients (33.3%) demonstrated the escape phenomenon in according to the results of at least one of the measurement methods. There weren’t differences between two groups (with and without the escape phenomenon) by the classical cardiovascular risk factors. In one-factorial logistic regression models, analyzed data of the inclusion stage, the next predictors of the escape phenomenon were found out: 24SBP>124 mmHg (OR 25,8, 95% CI 5,6 – 119,1, p = 0,00002), D-SBP>125 mmHg (OR 12,14, 95% CI 3,29 – 44,77, p = 0,0001), N-SBP > 110 mmHg (OR 6,5, 95% CI 2,34 – 18,00, p = 0,0002). In multifactorial logistic regression model, assessed the D-SBP and N-SBP data of the inclusion stage, both factors became independent predictors of the escape phenomenon (OR 10,28, 95% CI 2,67 - 39,57, p = 0,0006; OR 5,57, 95% CI: 1,74 - 17,87, p = 0,003 resp., pic. 1).Conclusions: It is defined a significant reducing of the OR of delayed AHT inefficiency, in case of sucsesful achievement the next target BP levels: 24SBP<124 mmHg, D-SBP<125 mmHg, N-SBP<110 mmHg.

Objective: The main aim of study was to investigate the association between subcutaneous (SF), visceral (VF), periaortic (PF), epicardial (EF) fat and arterial stiffness in patients with abdominal obesity (AO). Design and method: Patients 18–45 y.o. (average age 37,3 ± 6,9) with AO (n = 68; men(M) – 57,5%) were enrolled in study. Height, weight, BMI, waist circumference, blood tests (fast glucose (FG) and glucose tolerance(GT), lipid profile) were measured. Metabolic syndrome (MS) was defined as AO (cut-off of >80 cm in women(W) and >94 cm in M) plus >1 sign: HDL < 1,30(w)/1,04(m)mmol/l; triglycerides >1,69mmol/l; FG > 5,59mmol/l; violation GT; BP > 140/90 mmHg. Arterial stiffness was assessed by cardioankle vascular index (CAVI). SF, VF, PF, EF (range: −150 to −30 HU) was measured by computed tomography. We calculated ratio subcutaneous to visceral fat (RSV). 24hour blood pressure monitoring was performed. We formed 2 groups: AO (AO plus 1 or less sing of MS) and MS. Results: Tab. 1. Correlations with age r = 0,340 (p = 0,005), with daytime SBPm - (r = 0,280, p = 0,021), with volume of PF- r = 0,218 (p = 0,074) were found. An inverse correlation was found between CAVI and BMI - r = −0,279 (p = 0,021), with SF - r = −0,285 (p = 0,019) and with RSV r = −0,303 (p = 0,012). According to the multivariate regression analysis, the significant impact on CAVI is exerted by age, daytime SBPm, BMI, PF.Conclusions: SF and RSV are directly related to CAVI. Significant impact on CAVI is exerted by age, daytime SBPm, BMI, PF.

Objective: Was used data from epidemiological survey ESSE-RF (Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation) including adult population at the age of 25–64 y.o. of Siberian city Tomsk (n = 1538, including 58% females and 42% males). Design and method: Was used the systematic stratified multistage random sampling creating by the territorial principle of method by Keesh. Abdominal obesity (AO) was defined by waist circumference (WC) > 80 cm in women and 94 cm in men. MS was defined according to IDF, 2005. Diabetes mellitus 2 type (DM2) by fasting glucose > 6,9 mmol/l or < 7 mmol/l with hypoglycemic therapy. Statistic data calculation was done with computer-based statistic software STATISTICA 10.0 and SPSS 14.0.Results: Final analysis included 1538 persons. All examined persons have been divided into 4 groups depending on presence of obesity, metabolic syndrome (MS) and DM2, the 1st group included people without abdominal obesity (AO), MS and DM2 (n = 611). Patients with AO, but without MS (one additional risk factor was allowed) - metabolically healthy obese have been included into the 2nd group (n = 107). Patients with MS (n = 676) have been enrolled into the 3rd group. And patients with DM2 have been entered into the 4th group (n = 144). The prevalence of obesity in studied simple was 48,1% by BMI > 30 kg/m2 and 59% by WC. Arterial hypertension had 41,7% respondents: 15,4% in the 1st group, 32,7% in the 2nd group, 75% in the 3rd group and 92,3% in the 4th group. The prevalence of target organ damage (TOD) was growing from 1st group to 4th (Tab. 1). It was statistically significant (p < 0,0001). Conclusions: Study results showed high prevalence of obesity, especially AO (59%) in the investigated population, prevalence of MS also was high (43%), as well as DM 2 (9,3%). Cardiometabolic continuum (CC) is a progressive process and AO is fundamental to the pathophysiology of CC. Persons with metabolically healthy obesity already had the TOD. It could mean that AO without MS is a part of CC. Therefore patients with AO need more rigorous observe as early as possible.

Objective: Analysis of aortic stiffness using ultrasound-based technique in Takayasu aortoarteritis (TAA) patients with different inflammatory disease activity. Design and method: We studied 23 patients with TAA, all female, at the age of 39 (34;55) years and 34 healthy volunteers from the control group (15 men, 19 women) at the age of 43 (37;46)years. Pulse wave velocity in the aorta (aPWV) and local stiffness (stiffness index β) of the abdominal (AA) and thoracic aorta (TA) were measured by ultrasound method in all studied. High sensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) were determined to assess disease activity. Results: We found a significant increase of aPWV 9,3 (7,6;11)m/s in TAA patients compared to the control group 5,2 (4,8;5,5)m/s, (p < 0,0001). Local stiffness for βTA was significantly increased 11.8 (7,3;20), in comparison with the control group 4.9 (4,1;5,5),(p < 0,0001). The increase in stiffness index βAA in TAA patients was less pronounced 7.2 (4;11,4) in comparison with the control group 5,3 (4,8;5,8). The maximum increase in aortic stiffness was observed in patients with disease inflammatory activity in comparison with disease remission:βTA 32%-14 (8.6;19.5) compared to 10.6 (6.8;18.1); and aPWV 30%-11.2 (7.7;13.6)m/s compared to 8.6 (7;10.6)m/s, βAA 8%-7.8 (3.6;11) in comparison with 7.2 (4.5;11.4) respectively. aPWV showed moderate significant correlation with hsCRP-parameter of disease activity (r = 0.46, p = 0.03). Conclusions: Aortic stiffness is significantly increased in TAA patients and is higher in patients with disease inflammatory activity than that in patients with disease remission. In the analysis of the hsCRP and aPWV there is a moderate significant correlation, the study can confirm the view that one of the determinants of increased aortic stiffness is inflammatory activity in arterial wall.

Objective: To determine risk factors for the escape of the antihypertensive (AHT) therapy efficacy leading to a treatment adjusting during three months after hospital discharge.Design and method: The study included 59 patients with essential arterial hypertension (HT) grade 1–3, and without other cardiovascular disease (CVD), chronic kidney disease stage >3 or diabetes. Mean age was 55 ± 9 years, 29 men. Efficacy of the prescribed AHT drugs (2–3 medications from different AHT drug classes) was verified just before inclusion in the study by 24-hour blood pressure (24-BP) monitoring (using 24-BPM, BpLab) in the hospital. All included patients have achieved a mean 24-BP ∼ 130/80 mmHg. We monitored AHT therapy efficacy for 3 months following hospital discharge. Compliance was assessed by monitoring a ratio of taken and prescribed pills during office visits (at the 1st and 3rd month after hospital discharge). There were AHT therapy effectiveness criteria: office BP<140/90 mmHg (oscillometric method, OMRON), home BP<135/85 mmHg (oscillometric method, AND), 24-hour ambulatory BPM<130/80 mmHg (at the 1st and 3rd month after hospital discharge). In case of registering of higher levels of the BP by anyone method, we provided the AHT treatment adjusting. Results: Patients were divided into two groups by the presence (Group1, n = 29) or absence (Group2, n = 30) of indications for the treatment adjusting. The characteristics of groups and number of significant differences are shown in the Table1. Univariate logistic regression analysis was used with the following results: odds ratio (OR) for the escape of the AHT therapy efficacy increased by 18% with increase of the mean 24-SBP in each 1 mmHg (p = 0,004, OR = 1,18; 95% confidence interval (CI) 1,05–1,33), and by 60% with increase of the levels of the FG in each 0,5 mmol/l (p = 0,02, OR = 1,60; 95%CI 1,06–2,4). In the multivariate logistic regression analysis, independent risk factors for the escape of the AHT therapy efficacy were: family history of the early CVD (p = 0,03, OR = 3,7, 95%CI 1,1–12,1) and IGT (p = 0,04, OR = 4,1, 95%CI 1,02–16,4). Conclusions: There were detected risk factors for the escape of the AHT therapy efficacy: smoking, family history of the early CVD, IGT, level of the FG, mean 24-SBP.

Представлено описание комплексного подхода к исследованию нелинейных волновых процессов в сердечно-сосудистой системе человека, основанного на сочетании высокоточных методов измерения пульсовой волны, математических методов обработки эмпирических данных и методов прямого численного моделирования гемодинамических процессов в артериальном дереве.

Objective: Different diagnostic procedures of subclinical vascular damage detection are now suggested but unequal impact of cardiovascular risk factors on arterial wall is still discussed. The aim of our study was to assess the association of cardiovascular risk factors with subclinical vascular changes according to different diagnostic methods. Design and method: 452 apparently healthy participants aged 25–65 years were randomly selected from 1600 Saint-Petersburg inhabitants (a sample form ESSE-RF study). All participants signed informed consent and filled in the questionnaire regarding risk factors, concomitant diseases and therapy. Fasting lipids, glucose (Abbott Architect 8000 (USA)), anthropometry and BP measurement (OMRON, Japan) were performed. Cardio-ankle vascular index (CAVI) was measured by VaSera VS-1500 (Fukuda, Japan), carotid-femoral pulse wave velocity (cfPWV) was measured by SphygmoCor (Atcor, Australia). Statistical analysis was performed using SPSS Statistics 20. Results: Most of patients 341 (75,4%) did not have subclinical vascular damage by both methods and only 3 patients (0,7%) had. Increased arterial stiffness detected by CAVI assessment (33 (7,3%)) was found out significantly more often (p < 0,005) in comparison with cfPWV assessment (21 (4,6%)). According to results of multiple logistic regression adjusted by sex and age, probability to reveal increased arterial stiffness by applanation tonometry (OR = 11,2, 95%CI = 3,6–34,9, p < 0,0001) was higher in comparison with volumetric sphygmography (OR = 3,3, 95%CI = 1,2–10,6, p = 0,03) in hypertensive patients. Association of arterial stiffness with age and hyperglycemia was found out only by cfPWV assessment: (OR = 1,13, 95%CI = 1,06–1,19, p < 0,0001) and (OR = 2,5, 95%CI = 1,1–6,2, p = 0,04) respectively. Conclusions: Hypertension and hyperglycemia are associated with increased arterial stiffness assessed by applanation tonometry. Applanation tonometry seems to give the opportunity to reveal increasing of arterial stiffness at earlier stages of hypertension in comparison with volumetric sphygmography.

Objective: Arterial hypertension (AH) plays pivotal role in progression of endothelial dysfunction. Obesity and obstructive sleep apnea syndrome (OSAS) are two conditions also known to decrease endothelial function. The aim of this study was to explore differences in endothelial function in patients with AH with concomitant obesity and with or without OSAS. Design and method: In our study we enrolled male patients with AH and 10 healthy volunteers (group 1). Patients were divided into 3 groups: group 2 patients solely with AH (n = 17) (mean age 32 (28,39–35,61), BP 147,47 (145–149,94)/ 92,53 (87,72–97,34), BMI 27,06 (23,88–30,24)), group 3 (n = 15) patients with AH and obesity (mean age 36,67 (31,49–41,85), BP 149,2 (145,31–153,09)/ 89,27 (84,49–94,04), BMI 34,84 (32,68–37)), without OSAS (AHI 4,1 (3,58–4,62)) and group 4 (n = 20) patients with AH, obesity and severe OSAS (mean age 35,8 (33,01–38,59), BP 149,1 (144,5–153,7)/ 89,5 (85,01–93,99), BMI 35,71 (33,74–37,67), AHI 59,3 (48,66–69,93)). All groups were matched in terms of age, BP and BMI (for group 3 and group 4).Cut-off values for detection of vasomotor endothelial dysfunction were: delta PWV < 5,1 (by VaSera), index occlusion amplitude (by Angioscan) < 2,0, the phase shift between the channels before and after occlusion (by Angioscan) < 10,0. Results: FMD% (flow-mediated vasodilation) was lower in all groups in comparison with control group, though we didn’t show statistically significant differences between groups 2, 3 and 4. With delta PWV% were observed just the tendency for decrease. Index occlusion amplitude was lowest in the group 4, but significant difference was only in comparison with group 2. The phase shift between the channels before and after occlusion was lower in groups 3 and 4 in comparison with group 1; and in group 4 was lower vs group 2.Conclusions: In our study we didn’t obtain additional deterioration of endothelial function in patients with AH, obesity and severe OSAS in comparison with patients with AH and obesity. In terms of microvascular endothelial dysfunction the presence of severe OSAS led to additional impairment in comparison with patients solely with AH. Results could be limited to the number of enrolled patients.

Objective: We study the effect of renal denervation (RDN) on arterial stiffness and arterial functional in patients with resistant hypertension 6 months after RDN. Design and method: We examined 21 patients, average 57 ± 10 years, before and 6 months after successful RDN. Initially mean blood pressure was 174 ± 12 mmHg. All patients continued take the original multicomponent antihypertensive therapy unchanged. Arterial stiffness was determined by volume sphygmograph (VaSera 1000) we assessed pulse wave velocity aortic (PWA) and cardio-ankle vascular index (CAVI); by applanation tonometry (SPhygmoCor) - carotid-femoral pulse wave velocity (PWVcf); by ultrasound method echo-TRACKING technology (Aloka Prosound α7) - stiffness index (B), modulus of elastic deformation (Ep), artery distensibility (AC). Endothelial function was evaluated by finger photoplethysmography during reactive hyperemia (Angioscan-01). We assessed the occlusion amplitude index for the determination of endothelial function in the microvasculature and the occlusion phase shift index for the determination of endothelial function in the arteries of muscular type. Six months after RDN 12 patients were classified as responders (mean systolic BP was reduced on 10 mmHg and more). Results: At baseline arterial stiffness was increased in 19 patients (90%) by PWVcf, in 13 (62%) by CAVI, PWA – 8 (38%), index B – 4 (19%), EP – 10 (48%), AC – 5 (24%). Baseline endothelial dysfunction was found in 17 patients (81%) by occlusion amplitude index, in 18 (85%) by occlusion phase shift index. 6 months after RDN in responders PWVcf decreased from 13,7 ± 3,6 to 12,5 ± 3,1 m/s (p < 0,01), CAVI from 7,08 ± 3,4 to 6,02 ± 3,8 (p < 0,05), AC increased from 0,71 ± 0,32 to 0,93 ± 0,5 mm2/Kpa (p < 0,05). Endothelial dysfunction had tendency to positive change: occlusion phase shift index increased from 1,28 ± 0,67 to 1,42 ± 0,32 (p = 0,07). All parameters of arterial stiffness and endothelial function had not positive changes in nonresponders. Conclusions: After 6 months of RDN we detected the improvement of some indicators of arterial stiffness and tendency to improve endothelial function in responders.

Objective: Vascular age is the apparent age of the arteries that can be affected by genetic predisposition and lifestyle risk factors. Subjects whose vascular age is younger than chronological age might have lower cardiovascular risk. The aim of our study was estimate protective factors, which can be associated with younger vascular age in Russian population according to VaSera examination results.Design and method: 1600 apparently healthy participants aged 25–65 years were randomly selected from Saint-Petersburg inhabitants (ESSE-RF study). Fasting lipids, glucose (Abbott Architect 8000 (USA)) and blood pressure (BP) measurement by Omron (Japan) were performed. Cardio-ankle vascular index (CAVI) was detected by VaSera VS-1500 (Fukuda, Japan). We presumed definition of younger vascular age - it the biological age exceeded vascular age calculated from pressure independent stiffness index (CAVI) >4 years. Hypertension was considered as BP> = 140/90 mmHg or antihypertensive treatment, diabetes type 2 was considered as fasting glucose> = 7.0 mmol/l or treatment. Multiple regression analysis was applied (SPSS Statistics 20). Results: Data of 1361 subjects were suitable for analysis, 391 patients (28,7%) had vascular age younger than chronological (281 (71,8%) women and 110 (28,1%) men, Ð<0,001). These subjects were younger than other participants also according biological age (43,4±10,8 vs 45,8 ± 11,8 years, p < 0.05). Table 1. Determinants of younger vascular age in general population. Conclusions: Female gender was associated with higher probability to have a younger vascular age comparing to chronological age might be through higher HDL level despite the absence of direct associations. Dyslipidemia and hypertension decreased a probability to have younger vascular age.

Objective: Hypertension guidelines recommend ambulatory (A) blood pressure (BP), central BP and pulse wave velocity (PWV) as parameters for estimating BP control and vascular impairment. Recent advances in technology made available devices allowing combined non-invasive estimation of these parameters over the 24-h during ABP monitoring (ABPM). However, at present, there is limited evidence on the usefulness of such an approach for routine hypertension management. We recently launched an investigator-initiated, international, multicenter, observational, prospective study aiming at: i) evaluating non-invasive 24-h ABP and arterial stiffness estimates (through 24-h pulse wave analysis, PWA) in hypertensive subjects undergoing an ABPM for clinical reasons; ii) assessing the changes in estimates following treatment; iii) weighing the impact of 24-h PWA on target organ damage and cardiovascular prognosis; iv) assessing the relationship between arterial stiffness, BP absolute mean level and variability, and prognosis; v) validating use of the technique for hypertension screening. Design and method: Approximately 2000 subjects, referred to 20 hypertension clinics for routine diagnostic evaluation and follow-up of hypertension, will be recruited. Data collection will include ABPM, performed with a device allowing simultaneous non-invasive assessment of 24-h BP and arterial stiffness (BPLab), and clinical data (including cardiovascular outcomes). As recommended by current guidelines, each patient will be followed-up with visits occurring at regular intervals (ideally every 6 months, and not less than once a year). A web-based telemedicine platform (THOLOMEUS) will be used for data collection. The use of the telemedicine system will allow standardized and centralized data collection, data validation by experts and counselling to remote centers, setup and maintenance of the Registry, and prompt data analysis. Results: First follow-up results are expected to be available in the next 2-years. Conclusions: The results of the VASOTENS Registry will help defining the normalcy thresholds for current and future indices derived from 24-h PWA, according to outcome data. They will also provide supporting evidence for the inclusion of such evaluation in recommendations on hypertension management.

Objective: The aim of our study was to investigate the relationship between the orthostatic hypotensive reactions (OHR) identified active and passive OT in patients with AH older age groups (22 M, 49 F) with AH grade I-III, av.age 68,1 ± 5,8 years. During OT BP (beat to beat) measured continuously and non-invasively using the “Task Force Monitor “(“CNSystems” Austria). The criteria for IOH was considered the onset of symptoms of cerebral hypoperfusion associated with a reduction in SBP > 40 mmHg and DBP > 20 mmHg in the first 5–15 seconds orthostasis (Wieling W., 2006) and the identification of the initial uncompleted depressor reactions of BP (Rogoza A et al., 2008). Control of cognitive function was performed by a research brief mental status (MMSE), clock drawing test and concentration test by the method of TM. The statistical analysis was carried with Statistica 6.0. Results: In 22 (31%) patients was found the OHR. The groups were comparable by age (68,5 ± 5,5 vs 66,8 ± 5,9) yrs, gender (F 13 (59%) vs 37 (76%)); duration of AH (18,7 ± 11,7 vs 15,3 ± 10,6) years. The pts in the gr. with OHR had a more frequent strokes n = 3 (14%), without OHR – TIA in 4 pts (8%). Significant differences have been found between the groups by atherosclerotic lesions (40 < plaque < 65) of the carotid arteries (in gr. OHR 10 (45%) vs 3 (6%) without OHR, p < 0,05). The study revealed significant cognitive differences in patients with OHR and without OHR. Results of the test clock drawing OHR patients were lower than in patients without the PER (7,2 ± 1.4 vs 8,3 ± 0,8, p < 0,04), during the TM in patients with PER showed a reduction in attention (21,2 ± 2,4 vs 22,5 ± 1,17. p < 0,02). During the MMSE test revealed no significant differences (25,6 ± 2,45 vs 26,8 ± 1,3.p > 0.05). Conclusions: Hypertensive patients in older age groups with various types of OHR (the initial and classic) have a reduction of memory and attention, atherosclerosis of the carotid arteries, strokes in anamnesis compared with the same category of patients without the OHR.

Objective: To evaluate features of the functional state of microvascular bed of the skin in patients with idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Design and method: After clinical evaluation of 25 patients with IPAH (39,9 ± 13,1 years; 21 women/4 men, functional class (FC) II-III) and 22 patients with CTEPH (45,2 ± 14,9 years; 16 women/6 men, FC II-III) we performed laser Doppler flowmetry (LDF) with amplitude and frequency wavelet analysis of oscillations of blood flow and functional tests (constrictor and dilatator) for research the microvessels of the skin. The hydration degree of the interstitial space in the skin was evaluated by size of pericapillary space (PS) on capillaroscopy. Results: IPAH and CTEPH groups were comparable in age, 6-minute-walk distance (6MWD), mean pulmonary artery pressure (mPAP), but differed significantly in cardiac index (CI) at right heart catheterization (2,17 ± 0,59 and 1,81 ± 0,48 l/min/m2, p = 0.028). According to the LDF at the basal perfusion patients with CTEPH have higher (p < 0.05) the amplitude venular rhythm than patients with IPAH (0,153 ± 0,097 and the 0,118 ± 0,078 AU). According to functional testing patients with IPAH have tendency to increase constrictory activity of venous occlusion - 63% and 53%, respectively (p = 0.079) and a trend toward reduction of thermal vasodilation 513% and 614% (p = 0.087). According capillaroscopy in patients with IPAH noted trend toward lower values PZ relatively patients with CTEPH - 122 ± 16,4 μm and 114 ± 27,7 μm (p = 0.097). The amplitude of the venular rhythm, whose value reflects the degree of venular hyperemia, correlates with 6MWD – r = -0,46 (p = 0.0017), CI – r = -0,39 (p = 0.0084). The degree of hydration of the interstitial space (PS) correlates with 6MWD – r = -0,29 (p = 0.0576), CI – r = -0,27 (p = 0.0819). Conclusions: Despite higher CI, patients with IPAH have functional disorders at the level of microvascular bed of the skin, characterizing increase constrictory activity and a decrease dilatatory reserve.