Introduction/Objective: Tobacco smoking is a well-known risk factor for cardiovascular and renal diseases. In recent years, alternative types of smoking, including vaping, have been becoming popular. The contribution of vape to vascular and renal injury is not known. We studied the relation between smoking of traditional/electronic cigarettes and arterial stiffness and albuminuria, which is also a vascular dysfunction marker. Methods: We examined 270 young volunteers without significant clinical cardiovascular diseases (mean age: 21.2 ± 2.3 years). Twenty-seven percent of the subjects in the study group were smokers; 69.9% of them smoked traditional cigarettes and 30.1% smoked electronic cigarettes. The urine albumin level was assessed by a dipstick test, and the augmentation index was determined by photoplethysmography. A linear correlation test and multiple regression analysis were applied. Results: The study groups did not differ in basic characteristics. The smokers demonstrated generally higher blood pressure levels and were overweight. Most of the smokers were male. In the groups of smokers, albuminuria was more frequent, especially among vapers (94 vs. 79% in tobacco smokers and 29% in nonsmokers). AU values (median [quartile 25; quartile 75]) were significantly higher in vapers (160 mg/L [150; 207.5]) vs. tobacco smokers (115 mg/L [60; 200]) and vs. nonsmokers (20 mg/L [10; 50]) (р < 0.05). Photoplethysmographic results showed relevant higher augmentation indices among tobacco smokers (–4, [–6.6; –1.9]) and vapers (–5.05 [–13.4; –3.3]) compared to nonsmokers (–16.2 [–23.9; –7]) (р < 0.05). Results of multiple regression analysis demonstrate that smoking of both traditional and electronic cigarettes is related to an increase in the albuminuria level and the augmentation index. Conclusions: Smoking of both traditional and electronic cigarettes is related to albuminuria and an increase in the augmentation index, which is a noninvasive marker for arterial stiffness.

The сlinical guidelines present the main approaches to the management of patients with arterial hypertension (aH) using the principles of evidence-based medicine. The guidelines include sections containing expanded and updated information on the main aspects of diagnosis, treatment, prevention methods and follow-up patients with hypertension, taking into account the phenotypes of disease and various clinical situations, as well as secondary forms of hypertension of various origins.

The coronavirus pandemic showed not only an increase in levels of excess morbidity and mortality in the acute phase, but also persisting symptoms 4 weeks after the onset of the disease. A review of international studies on the prevalence and diversity of the manifestations of postcoid syndrome is presented. The data on such a manifestation of post-COVID syndrome as postural orthostatic tachycardia syndrome (POTS) are accumulating. Pathogenetic mechanisms, modern diagnostic criteria and research data on the prevalence of this syndrome are presented in the article. The Canadian Cardiovascular Society has proposed medications as a treatment for POTS, including the sinus node If channel inhibitor ivabradine. Data from several studies showing the effectiveness of this drug for POTS, including after suffering COVID-19, are presented in the article. Clinical data on the prevalence of tachycardia among patients admitted to the Sechenov University hospital are presented. About 18% of patients with hypertension and 21% of patients with normal blood pressure had a high heart rate. A clinical example of the use of ivabradine in a patient after a coronavirus infection is presented. Drug interactions and individual tolerance of ivabradine in patients after coronavirus infection are being discussed. The authors put forward the hypothesis about the further prospect of using ivabradine in the treatment of clinical manifestations of postcoid syndrome on the basis of literature data and their own experience.

Aim. To assess the association of hypertension with the severe forms and fatal outcomes of Coronavirus disease 2019 (COVID-19).Material and Methods. This retrospective cohort study involved adult patients (≥18 years old), admitted to the University hospital №4 of Sechenov University (Moscow, Russia) between 08 April 2020 and 19 November 2020 with clinically diagnosed or laboratory-confirmed COVID-19. The cohort included 1637 patients. The primary outcome was all-cause in-hospital mortality. The secondary outcomes included intensive care unit admission (ICU) and invasive ventilation. Multiple logistic regression was performed to assess the independent association between risk factors and endpoints.Results. A total of 1637 patients were included in the study. 51.80% (n=848) of the subjects were males. The median age was 59.0 (48.0; 70.0) years and 55.90% (n=915) had pre-existing diagnosis of hypertension. Patients with hypertension had significantly more severe lung injury based on chest CT scan findings as well as lower oxygen saturation (SрO2). More of them were admitted to ICU and placed on invasive ventilation. The hypertension group also had higher mortality. Age, hypertension, glucose, C-reactive protein and decreased platelet count were independently associated with mortality, hypertension having the strongest association (OR 1.827, 95% CI 1.174-2.846, p=0.008). Age, hypertension, neutrophil count, platelet count, glucose, and CRP were independently associated with ICU admission, with hypertension having the strongest association (OR 1.595, 95% CI 1.178-2.158, p=0.002). Age, hypertension, glucose, CRP and decreased platelet count were independently associated with invasive ventilation, with hypertension having the strongest association (OR 1.703, 95% CI 1.151-2.519, p=0.008).Based on the multiple logistic regression models, odds of death, ICU admission, and invasive ventilation were higher in the hypertension group as compared to the group without hypertension.Conclusion. Hypertension can be an independent predictor of severe COVID-19 and adverse outcomes, namely death, ICU admission, and invasive ventilation in hospitalized patients.

Arterial hypertension is both the cause and the result of the progression of chronic kidney disease, which affects about 10-15% of the population worldwide and the prevalence of which is steadily increasing. As the glomerular filtration rate decreases, the blood pressure level rises respectively. Arterial hypertension (AH) and chronic kidney disease (CKD) are independent and well-known risk factors for the development of cardiovascular diseases, and their combination significantly increases the incidence and mortality from cardiovascular disease. Blood pressure control is the most important factor in slowing the progression of CKD and reducing cardiovascular risk. Currently, there is a place for discussions in the scientific community regarding the target blood pressure levels in patients suffering from CKD. Non-pharmacological methods of treatment can reduce the level of blood pressure in some cases, but do not help to achieve the target values in most of the cases. Patients with hypertension and CKD need combined drug therapy. Certain modern drugs have additional cardio- and nephroprotective properties and should be considered as the first line of therapy. A personalized approach based on evidence-based principles makes it possible to achieve blood pressure control, reducing cardiovascular risk and slowing the progression of CKD. This consensus summarizes the current literature data, as well as highlights the main approaches to the management of patients with hypertension and CKD.

Aim. To study the relationship between the volume of perivascular adipose tissue (PVAT) and the vascular wall lesion.Material and methods. The study included 318 patients without cardiovascular disease (mean age, 63,5±13,7 years). Hypertension was detected in 268 (84,3%) patients. All patients underwent assessment of anthropometric characteristics, lipid profile, arterial wall stiffness with the estimation of cardio-ankle vascular index, intima-media thickness, brachial artery endothelial vasomotor function. Chest computed tomography was performed with the estimation of the volumes of PVAT and pericardial adipose tissue (PAT).Results. The volume of PVAT, on average, was 0,3 [0,2; 0,4] cm3 . The VAT volume was significantly higher in obese individuals when compared with patients with normal body weight: 0,4 [0,3; 0,5] vs 0,25 [0,2; 0,4] cm3 (p=0,0007). The VAT volume was higher in individuals with an increased CAVI level when compared with patients with normal CAVI values: 0,4 [0,3; 0,5] vs 0,3 [0,25; 0,3] (p=0,02). A significant correlation was found between the VAT volume and body mass index (r=0,27, p<0,005), waist circumference (r=0,41, p<0,005), CAVI (r=0,49, p<0,05), impaired endothelium-dependent brachial artery vasodilation (r=0,38, p<0,05). When performing multiple linear regression, a significant relationship of CAVI was found with age (β±SE, 0,51±0,15; p=0,002) and volume of PVAT (β±SE, 0,41±0,13; p=0,005).Conclusion. The results indicate the relationship of PVAT with visceral obesity and vascular wall stiffness parameters.