Aim. To assess the incidence of cardiovascular and cerebrovascular events in patients with controlled and uncontrolled hypertension, controlled resistant and uncontrolled resistant hypertension, refractory hypertension, and probably resistant and probably refractory hypertension. Materials and methods. A telephone call was made to 256 patients with hypertension included in the database to assess the incidence of cardiovascular and cerebrovascular diseases. All responding patients were divided into 7 groups according to the classification of hypertension based on the achievement/non-achievement of target blood pressure values and the number of drugs taken (controlled and uncontrolled hypertension, controlled resistant and uncontrolled resistant hypertension, refractory hypertension, and probably resistant and probably refractory hypertension). The target blood pressure was considered to be less than 140/90 mm Hg. Patients not adhering to medication were not included in the analysis. Results. The group of controlled hypertension included 146 (57%) patients out of 256, controlled resistant hypertension 36 (14%) patients, uncontrolled hypertension 6 (2.3%) patients, resistant uncontrolled hypertension 22 (8.6%) patients, refractory hypertension 31 (12.1%) patients. The group of probably resistant hypertension 6 (2.3%) patients, probably refractory hypertension 9 (3.5%) patients. Of the 28 events that occurred, 6 were attributed to coronary artery disease (including 3 acute myocardial infarction and 2 coronary artery stenting), 3 strokes, 6 episodes of transient ischemic attack and 10 new cases of atrial fibrillation, and 2 patients had sudden cardiac death. Significantly more often, patients with refractory hypertension developed any event compared with patients with controlled (38.7% versus 3.4%; p=0.005) and resistant hypertension (38.7% versus 13.6%; p=0.04). Also, patients from the group of probably refractory hypertension were more likely to develop events than patients with controlled hypertension (33.3% versus 3.4%; p=0.045). Patients with probably refractory hypertension significantly more often had a stroke than patients with controlled hypertension (22.2% versus 0%; p0.05), and patients with refractory hypertension significantly more often had a transient ischemic attack compared with patients from the group of controlled hypertension (12.9% versus 0.7%; p=0.03). Conclusion. Patients with refractory and probably refractory hypertension are significantly more likely to develop cardiovascular and cerebrovascular complications than patients with controlled hypertension.

Aim. To study the main risk factors, clinical, laboratory and instrumental data, concomitant cardiovascular diseases (CVD) and associated clinical conditions in patients with controlled and uncontrolled hypertension, controlled resistant and uncontrolled resistant hypertension, refractory hypertension, and probably resistant and probably refractory hypertension based on retrospective analysis. Materials and methods. The study included 455 patients with hypertension. All patients were divided into 7 groups. The group of controlled hypertension included 240 patients (52.75%), controlled resistant hypertension 61 (13.4%), uncontrolled hypertension 10 (2.2%), uncontrolled resistant hypertension 53 (11.65%), refractory hypertension 63 (13.8%), probably resistant hypertension 15 (3.3%), probably refractory hypertension 13 (2.9%). Anamnesis (assessment of the duration and age of the onset of arterial hypertension, assessment of the presence of CVD), risk factors for the development of hypertension (obesity, dyslipidemia, impaired glucose tolerance and fasting glycemia, hyperuricemia, family history of CVD, early menopause in women; heart rate 80 beats/min, smoking), laboratory parameters (creatinine, glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, uric acid) and instrumental methods of examination (ECG, echocardiography, clinic mean 24h BP, Holter monitoring, duplex BCA scanning) were assessed in all groups of patients based on the analysis of the medical history. Results. In this article we presented the results of a comparative analysis of patients with controlled hypertension, uncontrolled resistant hypertension, refractory and probably refractory hypertension. Patients with refractory hypertension were significantly more young, non-smokers and females compared with patients with uncontrolled resistant hypertension and controlled hypertension. Patients with refractory hypertension had greater prevalence of left ventricular hypertrophy according to ECG and echocardiography (p0.05). Fundus lesions were found exclusively in patients with uncontrolled hypertension, 55% of cases were found in the group of refractory hypertension (p0.05). There were no significant differences in the presence of BCA atherosclerosis between the groups. Patients with refractory hypertension were significantly more likely to have heart failure, a history of stroke and transient ischemic attack compared with patients from the group of controlled hypertension (p0.05). There was no significant difference in the presence of chronic kidney disease, type 2 diabetes mellitus, coronary heart disease, atrial fibrillation between the groups. Conclusion. Patients with refractory hypertension are significantly more likely to have target organ damage and concomitant cardiovascular, cerebrovascular diseases than patients with controlled hypertension.

Patients with arterial hypertension represent a special population group with a high risk of developing cardiovascular diseases. The most difficult to control are resistant and refractory hypertension. It is known that patients with uncontrolled hypertension have a worse prognosis, both in terms of cardiovascular events and all-cause mortality. This review presents topical issues related to the features of pathogenesis, treatment and prognosis in patients with refractory and refractory hypertension.

На сегодняшний день, учитывая увеличение числа пожилых больных с несколькими сопутствующими заболеваниями и нуждающихся в проведении транслюминальной баллонной коронарной ангиопластики, также возрастает и риск развития нежелательных осложнений данного вмешательства. В данной статье представлен клинический случай, где проведение транслюминальной баллонной коронарной ангиопластики осложнилось развитием перипроцедурного инфаркта миокарда (также известного как инфаркт миокарда 4а типа) без контраст-индуцированного острого повреждения почек.

In recent years, there has been an increase of patients with arterial hypertension, one of the variants of which is refractory arterial hypertension. This unfavorable clinical variant of the course of hypertension worries clinicians, due to the higher risk of developing cardiovascular complications, realizing the need for a better control of blood pressure. The presented clinical case demonstrates the successful combined treatment of refractory hypertension using antihypertensive therapy and renal denervation.

Nowadays, taking into account the number of elderly patients with sеveral associated diseases requiring percutaneous transluminal balloon coronary angioplasty (PTCA), the risk of the development of unwanted complications is also growing. In this article we present the clinical case, where the PTCA had complications with myocardial infarction of the 4a type without contrast-induced acute kidney injury (contrast-induced nephropathy).

Пациенты с наличием сердечно-сосудистых заболеваний (ССЗ) представляют особую уязвимую группу населения в условиях пандемии коронавирусной инфекции COVID -19. Они наиболее подвержены риску заражения, тяжелому течению заболевания, а также более высокой летальности по сравнению со здоровой популяцией. В настоящее время отсутствуют рандомизированные клинические исследования, позволяющие определить наиболее эффективные подходы к лечению у данной категории больных. Представленный клинический пример демонстрирует возможности применения различных групп препаратов, рекомендованных для лечения COVID-19 и высокую эффективность терапии ингибитором рецептора интерлейкина – 6 (ИЛ-6) у пациента с тяжелым течением новой коронавирусной инфекции и наличием сопутствующей сердечно-сосудистой патологии.Patients with cardiovascular disease represent a particularly vulnerable population in a pandemic of the coronavirus infection COVID -19. They are more at risk of infection, a severe course of the disease, as well as a higher mortality rate compared to a healthy population. Currently, there are no randomized clinical trials to determine the most effective approaches to treatment in this category of patients. The presented clinical example demonstrates the possibilities of using various groups of drugs recommended for the treatment of COVID-19, and the high efficiency of treatment with an interleukin-6 receptor inhibitor (IL-6) in a patient with severe new coronavirus infection and the presence of concomitant cardiovascular pathology.