Introduction. Type 2 diabetes (T2D) increases the risk of developing cardiovascular diseases, which leads to a high mortality in this category of patients. Issues regarding the prevention of the onset and progression of coronary heart disease (CHD) and chronic heart failure (CHF) in patients with T2D and/or metabolic syndrome (MS) are still not fully understood. The use of metabolic drugs with cardioprotective effects, in particular Mildronate®, is one of the possibilities to improve the effectiveness of combination treatment of CHD and CHF. Aim. To study the effect of Mildronate® on the quality of life (QoL) of patients with CHD and CHF, suffering from T2D and/or MS. Materials and methods. A total of 2.084 patients with co-occurring two (or more) disorders: obesity, type 2 diabetes, angina pectoris, CHT, and CHF were included in the INDICOR observational study conducted in real-life clinical practice settings. Group 1 received therapy with disease-modifying agents prescribed due to CHD and T2D; Group 2 received Mildronate® at a dose of 1000 mg per day in addition to the same therapy. The studied lab test results were assessed at baseline and 42 days of therapy. Results. A 42-day course of therapy in patients receiving Mildronate® at a dose of 1000 mg per day in addition to disease-modifying therapy (DMT) contributed to a percentage increase in the number of patients with CHD, FC (functional class) I angina pectoris (Δ,% + 63%, p < 0.001 ) as compared to the control group with no significant changes (Δ,% + 7%, p > 0.5). A significant increase in the number of patients with FC I CHF was recorded in Group 2 (from 23.5 to 42.1%, Δ,% + 79%) as compared to Group 1, where no significant changes were detected (22.7 to 23.7%, Δ,% + 4%). The QoL in patients with CHF based on data collected using the Minnesota Questionnaire and QoL in patients with CHD based on data collected using the Seattle Questionnaire significantly improved in the groups that received Mildronate® in addition to DMT, as compared with the group of patients who were only on DMT. Conclusion. Results from the Seattle and Minnesota questionnaires showed that the use of Mildronate® as part of combination therapy in patients with CHD and CHF, suffering from T2D and/or MS, contributed to a significant reduction in the frequency of angina attacks and lowering angina FC, CHF FC, and also enhanced the quality of life in this category of patients.

Objective: to evaluate the feature of microcirculation condition and left ventricle remodulation type in patients with arterial hypertension (AH) and lower extremity arteries atherosclerosis (LEAA).Materials and methods: one hundred patients from 45 to 65 years old were included in this research. The main group consisted of 50 patients with arterial hypertension and lower extremity arteries atherosclerosis and the control group included 50 patients with AH and without LEAA. Laser doppler flowmetry and echocardiography were performed for all patients.Results: there were lower values of microcirculation index (26,54[10,51–29,25] vs 37,3[26,59–40,24], р=0,0001), Am (0,25[0,22–0,32] vs 0,36[0,35–0,48], р=0,001) и Аe (0,47[0,42–0,47] vs 0,50[0,50–0,58], р=0,001), capillary reserve (134,5[126,7–151,8] vs 166,4[153,2–166,4], р=0,001). Breathe test index (41[17,93–77,74] vs 47,7[19,93–47,76], р=0,013) and higher value of bypass indicator (1,95[0,63–2,26] vs 1,31[1,13–1,31], р=0,0001) in patients with arterial hypertension and lower extremity arteries atherosclerosis compared to patients with isolated AH. Spastic (46% vs 14% р=0,0002) and spastic–atonic (30% vs 0%, р=0,0001) microcirculation types were reliably more often in main group compared to control group, whereas normal (0 vs 38%, p=0,0001) and stagnant (24% vs 48%, р=0,001) types were reliably rare. Concentric (62% vs 38%, р=0,004) and eccentric (8% vs 0%, р=0,0001) left ventricle hypertrophy (LVH) were found veraciously more frequently in patients with arterial hypertension and LEAA than in patient with AH and without LEAA. The binary logistic regression model was performed. It was determined that LVH risk was higher due to microcirculation index and capillary reserve decreasing in patients with arterial hypertension and lower extremity arteries atherosclerosis.Conclusion: spastic and spastic–atonic microcirculation types were reliably more often in main group compared to control group Endothelial disfunction, decreased tissue perfusion increased microcirculatory bypass and blood stagnation were detected in patients with AH and LEAA compared to patients with isolated AH. Concentric and eccentric left ventricle hypertrophy were found veraciously more frequently in patients with arterial hypertension and LEAA than in patient with AH and without LEAA and the risk of LVH was depended on microcirculation index and capillary reserve in patients of the main group.

Тhis article is devoted to the issues of etiology, pathogenesis, classification, description of the clinical picture, approaches to the diagnosis and treatment of such a clinical and laboratory syndrome as rhabdomyolysis. For a detailed acquaintance with this nosology, we provide an analysis of a clinical case, where we tried to set out in detail the main aspects and key points of a timely and correct diagnosis, as well as possible examples of diagnostic treatment. The given clinical example allows us to trace the development of the disease in a particular case, the possibilities of modern research methods in the diagnosis of this pathology, as well as to evaluate the effectiveness of the therapy.

Objectives:In hemodialysis patients, central hemodynamics, stiffness, and wave reflections assessed through ambulatory blood pressure monitoring (ABPM) showed superior prognostic value for cardiovascular (CV) events than peripheral blood pressures (BPs). No such evidence is available for lower-risk hypertensive patients.Methods:In 591 hypertensive patients (mean age 58 +/- 14 years, 49% males), ambulatory brachial and central BP, pulse wave velocity (PWV), and augmentation index (AIx) were obtained with a validated upper arm cuff-based pulse wave analysis technology. Information on treatment for hypertension (73% of patients), dyslipidemia (27%), diabetes (8%), CV disease history (25%), was collected. Patients were censored for CV events or all-cause death over 4.2 years.Results:One hundred and four events (24 fatal) were recorded. Advanced age [hazard ratio and 95% confidence interval: 1.03 (1.01, 1.05), P = 0.0001], female sex [1.57 (1.05, 2.33), P = 0.027], CV disease [2.22 (1.50, 3.29), P = 0.0001], increased 24-h central pulse pressure (PP) [1.56 (1.05, 2.31), P = 0.027], PWV [1.59 (1.07, 2.36), P = 0.022], or AIx [1.59 (1.08, 2.36), P = 0.020] were significantly associated with a worse prognosis (univariate Cox regression analysis). The prognostic power of peripheral and central BPs was lower. However, PWV [1.02 (0.64, 1.63), P = 0.924], AIx [1.06 (0.66, 1.69), P = 0.823], and central PP [1.18 (0.76, 1.82), P = 0.471], were not significant predictors in multivariate analyses.Conclusions:In hypertensive patients, ambulatory central PP, PWV, and AIx are associated with an increased risk of CV morbidity and all-cause mortality. However, this association is not independent of other patient characteristics.

The relationship between the formation of non-alcoholic fatty liver disease (NAFLD) in obese individuals has been proven, which increases the patient’s cardio-metabolic risk. A number of studies have demonstrated that patients with normal body weight (NBW) have comparable risks of developing cardiovascular disease and progression to NAFLD compared to obese patients. Purpose of the study: To assess the incidence of cardio-metabolic disorders in patients with NAFLD and NBW. Materials and methods: 225 patients of both sexes (18–65 years old) with confirmed NAFLD were included. Patients were divided into 3 groups according to body mass index (BMI) values. Results: In patients of group 1, an increased risk of developing coronary heart disease (CHD), arterial hypertension (AH), type 2 diabetes mellitus and progression of liver fibrosis was revealed with an increase in the level of the triglyceride index. Conclusions: The study demonstrated the need for early identification of NAFLD in NBW individuals and assessment of existing cardiometabolic risk factors.

Background and Aims: to evaluate the effect of visceral obesity on the elasticity of the main arteries in patients with arterial hypertension (AH), obesity, type 2 diabetes mellitus (DM). Methods: 320 patients with II-III AH 45-70 years old were divided into 4 groups: "isolated" AH (Group 1), AH and obesity (Group 2), AH, obesity and 2 DM (Group 3), AH and DM 2 without obesity (Group 4). The clinical status, parameters of visceral obesity, elasticity of the main arteries were assessed. Results: At least 50% of all patients had visceral obesity, despite the absence of obesity in terms of body mass index in groups 1 and 4: 57.5 vs 100.0 vs 100.0 vs 50.0% in groups 1, 2, 3 and 4 groups, respectively (p<0.0001). A higher percentage of individuals with adipose tissue dysfunction was noted in groups 2 and 3 compared to groups 1 and 4 (75% vs 81.1% vs 41.5% vs 53.4%, respectively, p1-2 <0.001, p1-3<0.001, p2 -4 = 0.023, p3-4 = 0.002). The percentage of persons with a pulse wave propagation velocity (PWVE) >10 m/s was more common among patients of group 3 compared with patients of groups 1 and 2 (77.0 vs 57.9 and 55.3%, p1-3= 0.004, p2-3=0.006). It was revealed the relationship between indicators of visceral obesity, the elasticity of the main arteries and the 5-year risk of cardiovascular complications. Conclusions: The features of the influence of visceral obesity on the elasticity of the main arteries in patients with AH were revealed as obesity and type 2 diabetes were added to it.

Оbjective : to evaluate the features of daily monitoring of arterial and central aortic pressure in patients with arterial hypertension and non-alcoholic fatty liver disease. Materials and methods: a comparative cross-sectional study was conducted, which involved 120 patients (continuous sample, unorganized population), aged 45 to 65 years (mean age 56.2±8.8 years), including men (34 (28.3%) with AH stage I–II, 1–2 degree. The main group included 60 patients with hypertension and NAFLD, the control group included 60 patients with isolated hypertension. When examining patients, a clinical examination was carried out: taking an anamnesis, measuring "office" blood pressure, anthropometric parameters, calculating body mass index (BMI), WC. 24-hour monitoring of arterial (ABPM) and central aortic pressure (CAP) was assessed using the BPLab complex and Vasotens 24 software (LLC Petr Telegin, Russia). The SCORE scale was used to calculate total cardiovascular risk and 10-year fatal risk. Results : all patients of the study groups underwent ABPM. It was proved that in the patients of the main group, the IV SBP and IV DBP during the day and night significantly exceeded the similar parameters of patients in the comparison group (IV SBP: p=0.0019, p=0.007; IV DBP: p=0.009, p=0.009, respectively). One of the important criteria for assessing blood pressure was the determination of the degree of nighttime decrease in SBP and DBP — the daily index (SI), characterizing the balance in the work of the sympathetic and parasympathetic parts of the autonomic nervous system. In the main group, compared with the control group, there were more patients with SI DBP in the range from 0.0% to 10.0% (non-dipper) (p=0.034), with an increase in SBP at night (night-picker) (p=0.031). When assessing the parameters of CAP, in patients with AH and NAFLD, statistically significantly higher values of mean daily systolic (SADAo) and diastolic (DADo) aortic pressure were observed (p=0.016, p=0.039, respectively), SBP in the daytime (p=0.027), SADao and DADAO at night (p=0.002, p=0.003, respectively), compared with patients with isolated hypertension. Calculation of the risk of cardiovascular complications, in patients with hypertension and NAFLD, a significant increase in the 10-year risk of cardiovascular events was determined, compared with patients with isolated hypertension (3.7 (1.6; 6.0) vs 2.0 (0.6 ;4.3) %, p=0.013). Conclusion : according to the results of 24-hour BP monitoring, in patients with AH and NAFLD, compared with patients with isolated AH, a more significant increase in mean SBP and DBP, an increase in the rate of morning rise and BP variability, and the hypertension time index were revealed. In the main group, patients with a nocturnal increase in SBP were detected significantly more often, which indicates a greater risk of cardiovascular complications in patients with hypertension and NAFLD. In addition, compared with patients with isolated AH, patients with AH and NAFLD showed more significant increases in average daily and nighttime SBPao and DADAO.

Syndrome of increased epithelial permeability (SPEP) is considered as one of the universal mechanisms that determine the subsequent development of chronic systemic inflammation of varying severity. Studies carried out in the last 10 years have shown the important role of SPEP in the pathogenesis of many diseases of internal organs, and, first of all, of the gastrointestinal diseases. The article discusses possible ways of correcting impaired epithelial permeability from the point of view of the cytoprotective effects of drugs most often prescribed to patients with gastrontestinal diseases.

Background and Aims: To assess the condition of the main arteries in patients with CHF with concomitant type 2 diabetes mellitus. Methods: 165 patients with CHF of functional class I–III (FC) of ischemic genesis aged 40 to 65 years were examined. All patients were divided into 2 groups depending on the presence of DM. Group 1 (n-86) is represented by patients with CHF without DM, group 2 (n-79) — patients with CHF and concomitant DM. To study the condition of the main arteries, the pulse wave propagation velocity (PWV) was determined along the elastic (PWVe) and muscular (PWVm) arteries. All patients underwent a test with post-occlusive reactive hyperemia. Results: In patients with CHF and DM, there was a significant increase in PWVe compared with patients with CHF without DM: 11.6 [9.3; 12.1] m/s vs 8.9 [8.1; 9.2] m/s in the 2nd and 1st groups, respectively. The frequency of occurrence of persons with SRPVe exceeding normal indicators was significantly higher in patients with CHF and DM than among patients with CHF without DM (78.7% vs 24.6%, respectively). PWVm/PWVe was more significantly reduced in the group of patients with CHF and DM. During the occlusion test in the group of patients with CHF and DM, normal reactivity of the main arteries is significantly less common (14.6% vs 31.8%). Conclusions: In patients with CHF with the same FC, significantly worse indicators reflecting the stiffness of the arterial wall were revealed among patients with concomitant diabetes.

Introduction. Currently, increased uric acid (UA) levels are considered an independent risk factor for the development of non-alcoholic fatty liver disease. Oxidative stress, chronic systemic inflammation, and insulin resistance characteristic of non-alcoholic fatty liver disease (NAFLD) may represent possible mechanisms for the association between the development of hyperuricemia and NAFLD. Aim. To clarify the meaning and nature of the relationship between an increase in the level of UA concentration and the development of NAFLD, as well as to evaluate the relationship between uric acid and the risk of cardiovascular complications in patients with hypertension and NAFLD. Materials and methods. A cross-sectional comparative study was conducted, which involved 120 patients aged from 45 to 65 with hypertension of 1–2 degrees, 1–2 stages (with and without NAFLD (FLI > 60). During the examination, a clinical examination was carried out: analysis of anamnesis data, anthropometry. Lipids and uric acid in blood plasma were also analyzed. Results. In the group of comorbid patients, there were significantly more patients with excess of the reference values of UA levels in the blood plasma (OR = 2.25: 95% CI 1.08–4.71). ROC analysis showed that with an uric acid level of 369.5 µmol/l, a high risk of developing NAFLD is predicted. The UA/Cr index in patients with hypertension and NAFLD was statistically significantly higher than in patients in the control group. Increase in the MK/Kr index by 1 USD increases the chances of developing NAFLD by 1.54 times (95% CI: 1.11–2.13). Also, an increase in the concentration of sUA level by 1 µmol/l increases the chances of an increase in the 10-year risk of cardiovascular events to 5.0% or more by 0.6%. Conclusions. With an uric acid level of 369.5 µmol/l, a high risk of developing NAFLD in the study group is predicted. Increase in UA/creatinine index by 1 USD increases the chances of developing NAFLD by 1.54 times. In addition, an increase in the concentration of sUA in the blood plasma by 1 µmol/l increases the chances of an increase in the 10-year risk of cardiovascular events to 5.0% or more by 0.6% in patients with hypertension and NAFLD.

Background and Aims: Aim. To study the relationship between the thickness of the epicardial adipose tissue and the stiffness of the main arteries in patients with chronic heart failure (CHF) and obesity

OBJECTIVE:Evaluation of the antiasthenic effect of sequential therapy with levocarnitine (LC) and acetylcarnitine (ALC) in patients with arterial hypertension and/or ischemic heart disease (CHD) with asthenic syndrome (AS).MATERIAL AND METHODS:An open comparative study included 120 patients aged 54-67 years in patients with arterial hypertension and/or coronary artery disease with AS. Patients of group1 (n=60), in addition to basic therapy for the underlying disease, received LC (Elcar solution for intravenous and intramuscular injection of 100 mg/ml, the company PIQ-PHARMA) intravenously for 10 days at a dose of 1000 mg/day, followed by a transition to oral administration of ALC (Carnicetine, the company PIQ-PHARMA) 500 mg (2 capsules) 2 times a day for 2 months. Group2 patients (n=60) received only basic therapy for major diseases. The duration of observation was 70 days. The severity of AS was assessed using the MFI-20 questionnaire (MultidiMensional Fatigue Inventory) and the visual analog scale VAS-A (Visual Analog Scale Measuring fatigue).RESULTS:In patients of group1, a statistically significant decrease in various manifestations of AS was noted. The differences were significant both in comparison with the baseline level and in comparison with the 2nd group. The endothelium-protective effect of LC and ALC has been established.CONCLUSION:The results obtained indicate that in such comorbid patients, the use of LC and ALC reduces the severity of AS manifestations, and the established endotheliotropic properties of the drugs allow them to be recommended as part of the complex personalized therapy of patients with cardiovascular diseases.

Non-alcoholic fatty liver disease (NAFLD) and hyperuricemia (HU) are currently considered by many authors as a manifestation of the metabolic syndrome (MS) and associated with insulin resistance (IR), increased body mass index (BMI), type 2 diabetes mellitus (DM2), cardiovascular disease (CVD). The latest data of numerous studies prove that HU is a significant risk factor for the development of not only obesity, DM2, CVD, but also NAFLD.

Background and Aims : Aim. To study the effect of systemic inflammation on the elasticity of the main arteries in patients with chronic heart failure (CHF) in combination with obesity.Methods: Material and methods. 142 patients with CHF I-III functional class 45-65 years were divided into 3 groups. Group 1 is represented by patients with "isolated" CHF, 2 - patients with CHF and overweight, 3 - patients with CHF in combination with obesity. A standard examination was performed, the stiffness of the vascular wall was assessed by measuring the velocity of pulse wave propagation through the vessels of the muscular (PWVm) and elastic (PWVe) types, laboratory markers of systemic inflammation and endothelial dysfunction were determined.Results: Results. PWVe and the percentage of occurrence of PWVe >10 m/s are significantly higher in patients of group 3 compared to patients of group 1 (10.8 [9.3;11.6] vs 9.2 [7.8;10.7] m/s and 74 vs 42%, respectively). The concentration of C-reactive protein (CRP) was significantly higher in group 3 patients compared to group 2 and 1 (8,31 [5,12; 15,41] vs 5,64 [4,92; 6,31], 8,31 [5,12; 15,41] vs 3.08 [1.57; 6.98] mg/l, respectively). The level of endothelin-1 (ET-1) in serum increased from group 1 to group 3. Significant correlations were revealed between the concentration of CRP and PWVe (r=0.48), PWVm (r=0.47), ET-1 level (0.56); between ET-1 and PWVe (r=0.52), PWVm (r=0.49).Conclusions: Conclusion. Systemic inflammation has a negative effect on the elasticity of the main arteries, and also leads to the progression of endothelial dysfunction in patients with CHF in combination with obesity. Background and Aims : Aim. To study the effect of systemic inflammation on the elasticity of the main arteries in patients with chronic heart failure (CHF) in combination with obesity. Methods: Material and methods. 142 patients with CHF I-III functional class 45-65 years were divided into 3 groups. Group 1 is represented by patients with "isolated" CHF, 2 - patients with CHF and overweight, 3 - patients with CHF in combination with obesity. A standard examination was performed, the stiffness of the vascular wall was assessed by measuring the velocity of pulse wave propagation through the vessels of the muscular (PWVm) and elastic (PWVe) types, laboratory markers of systemic inflammation and endothelial dysfunction were determined. Results: Results. PWVe and the percentage of occurrence of PWVe >10 m/s are significantly higher in patients of group 3 compared to patients of group 1 (10.8 [9.3;11.6] vs 9.2 [7.8;10.7] m/s and 74 vs 42%, respectively). The concentration of C-reactive protein (CRP) was significantly higher in group 3 patients compared to group 2 and 1 (8,31 [5,12; 15,41] vs 5,64 [4,92; 6,31], 8,31 [5,12; 15,41] vs 3.08 [1.57; 6.98] mg/l, respectively). The level of endothelin-1 (ET-1) in serum increased from group 1 to group 3. Significant correlations were revealed between the concentration of CRP and PWVe (r=0.48), PWVm (r=0.47), ET-1 level (0.56); between ET-1 and PWVe (r=0.52), PWVm (r=0.49). Conclusions: Conclusion. Systemic inflammation has a negative effect on the elasticity of the main arteries, and also leads to the progression of endothelial dysfunction in patients with CHF in combination with obesity.

Background and Aims : Aim: to evaluate the effect of visceral obesity on the value of vascular age in patients with arterial hypertension (AH), obesity, type 2 diabetes mellitus (DM).Methods: 320 patients with stages II-III of AH 45-70 years old were divided into 4 groups: "isolated" AH (group 1), AH and obesity (group 2), AH, obesity and type DM (group 3), AH and DM without obesity (group 4). The clinical status, parameters of visceral obesity, and vascular age were assessed. Nonparametric statistical methods were used.Results: At least 50% of all patients had visceral obesity, despite the absence of obesity by body mass index in groups 1 and 4: 57.5 vs 100.0 vs 100.0 vs 50.0% in groups 1, 2, 3 and 4 groups, respectively (p <0.0001). The visceral obesity index VAI was significantly higher among 3 group in comparison with 1 and 4 groups (2.96 [2.36; 3.98] vs 1.87 [1.40; 2.67] vs 2.22 [1.61; 3.26] respectively). Vascular age was statistically significantly lower in group 1 in comparison with groups 3, 4 (64.0 [57.8; 71.0] vs 69.0 [62.0; 73.0] and 69.5 [66.0 ; 74.3] years, respectively), as well as in group 2 in comparison with 4 (64.0 [56.5; 70.5] vs 69.5 [66.0; 74.3] years).Conclusions: The features of the influence of visceral obesity on the value of vascular age in patients with hypertension were revealed as obesity and type 2 diabetes join it. Background and Aims : Aim: to evaluate the effect of visceral obesity on the value of vascular age in patients with arterial hypertension (AH), obesity, type 2 diabetes mellitus (DM). Methods: 320 patients with stages II-III of AH 45-70 years old were divided into 4 groups: "isolated" AH (group 1), AH and obesity (group 2), AH, obesity and type DM (group 3), AH and DM without obesity (group 4). The clinical status, parameters of visceral obesity, and vascular age were assessed. Nonparametric statistical methods were used. Results: At least 50% of all patients had visceral obesity, despite the absence of obesity by body mass index in groups 1 and 4: 57.5 vs 100.0 vs 100.0 vs 50.0% in groups 1, 2, 3 and 4 groups, respectively (p <0.0001). The visceral obesity index VAI was significantly higher among 3 group in comparison with 1 and 4 groups (2.96 [2.36; 3.98] vs 1.87 [1.40; 2.67] vs 2.22 [1.61; 3.26] respectively). Vascular age was statistically significantly lower in group 1 in comparison with groups 3, 4 (64.0 [57.8; 71.0] vs 69.0 [62.0; 73.0] and 69.5 [66.0 ; 74.3] years, respectively), as well as in group 2 in comparison with 4 (64.0 [56.5; 70.5] vs 69.5 [66.0; 74.3] years). Conclusions: The features of the influence of visceral obesity on the value of vascular age in patients with hypertension were revealed as obesity and type 2 diabetes join it.

Introduction. Patients with chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are increasingly found in the clinical practice. The comorbidity of CHF and COPD promotes high mortality in such patients. Therapy that is prescribed to patients with CHF and COPD may not always have a positive effect on the condition of blood vessels. In this regard, researchers began to pay attention to drugs that have a beneficial effect on blood vessels, without worsening the course of CHF and COPD, one of which is meldonium.The purpose of the study. To study the effect of meldonium as part of complex therapy on arterial stiffness and microcirculation in patients with CHF and COPD.Materials and methods. The open randomized study included 60 patients with CHF IIA stage, II–III functional class (clinical recommendations of RKO, OSSN 2020) and COPD of the I–III degree of airflow restriction (classification GОLD 2021) without exacerbation. The patients were divided into 2 groups: the 1st group – the main group (n = 30) with CHF and COPD, which was prescribed meldonium as part of complex therapy at a dosage of 1000 mg/day, the 2nd group – the control group (n = 30) was on therapy only with basic drugs of CHF and COPD. The observation period is 12 weeks.Results. As a result of 12 weeks of therapy with the inclusion of meldonium in the complex therapy of patients with CHF and COPD, a decrease in the stiffness of the main arteries, an improvement in the regulation and parameters of microcirculation, an increase in the frequency of occurrence of the normocirculatory type of microcirculation were noted.Conclusions. A significant useful effect of complex therapy with the inclusion of meldonium on the condition of arterial stiffness and microcirculation in patients with CHF and COPD has been established, which makes it possible to recommend the use of meldonium in this category of patients.