Аim. To study the influence of genetic factors on the severity of essential аrteriаl hypertension (AH) clinical outcomes in patients of Russian and Buryаt ethnicity.Methods. Our study included 206 patients with а diagnosis of essential AH: 136 patients were of Russiаn аnd 70 patients were of Buryаt ethnicity. Pаtients were evаluаted for the following genotype markers; АCE, АDRB1, АDRB2, АDRB3, NOS3, АGT, EDN1, GNB3, and STK39.Results. Allele T of GNB3 was аssociаted with high blood pressure in Russiаn аnd Buryаt patients. In Buryat patients, locus rs934379 of EDN1 was аssociаted with high blood pressure, whereas allele G of the same marker was associated with increased heart damage risk. In Russians, allele I of ACE was protective towards the development of left ventricular hypertrophy.Conclusion. Our data revealed ethnogenetic differences in the genetic features of essential AH. We identified the patients severe hypertension among two etnhic group. Studying ethnic genetic markers for essential AH facilitates a greater understanding of the genetic predisposition underlying this condition. Received 2 July 2020. Revised 31 August 2020. Accepted 9 September 2020. Funding: The work is supported by grant of the Russian Foundation for Basic Research (project No. 19-315-80032). Conflict of interest: Authors declare no conflict of interest. Author contributionsConception and design: N.V. Kokh, E.M. Zelenskаyа, G.I. LifshitsData collection and analysis: A.Yа. Kovаlevа, N.V. Kokh, E.N. Voroninа, O.S. Donirovа, E.M. Zelenskаyа, A.A. Slepukhina, G.I. LifshitsStatistical analysis: N.V. KokhDrafting the article: A.Yа. Kovаlevа, N.V. Kokh, E.N. Voroninа, O.S. Donirovа, E.M. Zelenskаyа, A.A. Slepukhina, G.I. LifshitsCritical revision of the article: A.Yа. Kovаlevа, N.V. Kokh, E.N. Voroninа, O.S. Donirovа, E.M. Zelenskаyа, A.A. Slepukhina, G.I. LifshitsFinal approval of the version to be published: A.Yа. Kovаlevа, N.V. Kokh, E.N. Voroninа, O.S. Donirovа, E.M. Zelenskаyа, A.A. Slepukhina, G.I. Lifshits

Связь генетических факторов риска с развитием артериальной гипертонии с учётом этнических различий

Modern medicine has successfully used the N-terminal pro-brain natriuretic peptide (NT-proBNP) as a biomarker for many cardiovascular diseases (CVDs). According to a number of studies, NT-proBNP may also play a role in the development of resistant hypertension (RH), but the existing work addresses this issue only indirectly. In turn, RH causes serious damage to the economic and social spheres, worsening the quality of life of patients. Thus, the complexity of verification and treatment of RH, the inconsistency of the described associations of NT-proBNP and RH makes this topic more relevant than ever.

The article discusses particular circumstances of acute coronary syndrome (ACS) in patients with type 2 diabetes (T2D). In addition, the available literature data and clinical guidelines reflecting the role of hypoglycemic therapy as a cardioprotection factor in ACS are analyzed. The article considers possible protective molecular mechanisms of various groups of drugs in ischemic cardiomyocytes.

Aim. To study the influence of atrial fibrillation on the severity of cognitive impairment in patients with arterial hypertension.Methods. The study included 25 patients with atrial fibrillation and arterial hypertension, the control group of 25 patients with arterial hypertension, but without cardiac arrhythmias. All patients underwent general clinical and instrumental examination of the cardiovascular system. The Montreal Cognitive Assessment test was used to assess memory and attention, the degree of mastering visual-constructive skills, abstract thinking and speech.Results. Cognitive functions in patients with atrial fibrillation were significantly worse than in patients in the control group (testing to assess indicators: 22.7 ± 3.2 and 25.6 ± 2.2 points, respectively, p < 0.001). Cognitive indicators such as memory, speech and abstract thinking are most severely affected in patients with arrhythmia.Conclusion. Atrial fibrillation creates conditions for the development of cognitive deficits. Cerebral hypoperfusion, the occurrence of "silent" cerebral infarctions and hypercoagulation are important pathogenetic factors of cognitive impairment in patients with atrial fibrillation. Received 29 July 2021. Revised 11 September 2021. Accepted 20 September 2021. Funding: The research was carried out within the state assignment of the Siberian Branch of the Russian Academy of Sciences (No. 121031300045-2). Conflict of interest: Authors declare no conflict of interest. Contribution of the authors: The authors contributed equally to this article.

Aim. To study the influence of hypoglycemic therapy on hospital and long-term prognosis in patients with acute coronary syndrome (ACS) and diabetes type 2.Methods. The study included 63 patients with ACS and type 2 diabetes. All patients had a clinical examination, assessment of mortality risk and myocardial infarction on GRACE scale (Global Registry of Acute Coronary Events) and TIMI (Thrombolisis In Myocardial Infarction) in-hospital and six months after hospitalization.Results. Metformin is associated with a lower estimated risk of in-hospital mortality and within 6 months after discharge in patients with acute coronary syndrome on the background of type 2 diabetes and with less risk of adverse cardiovascular events within 14 days of their occurrence in patients with unstable angina pectoris on the background of diabetes. High daily doses of metformin have also been associated with a decrease in the estimated risk of in-hospital mortality and within 6 months after discharge in patients with ACS associated with diabetes. The inverse association between the daily dosage of metformin and the presence of angina pectoris in patients with ACS and diabetes type 2 indicates a protective effect of metformin high daily dosages in relation to the risk of complications within six months after the discharge from hospital.Conclusion. One of the important aspects of ACS treatment, along with effective therapy, is the impact on concomitant risk factors, including blood glucose control. The main groups of hypoglycemic drugs have currently been identified; their effect on cardiovascular events, long-term effects and long-term prognosis are being investigated.