[Diagnosis and effective surgical treatment of constrictive pericarditis].

Constrictive pericarditis is a rare and severe disease. Timely and correct differential diagnosis of this pathology facilitates choice of necessary tactics of treatment and thus improve prognosis and quality of life. In this paper we present clinical case report of a patient with constrictive pericarditis.

[Microcirculatory disorders in hypertension, atherosclerosis, diabetes mellitus].

Fundamental investigations of the role of the endothelium and cell periphery in regulation of vascular tonicity in the last decade of the XX century brought a radical revision of the former conception of circulation. It was discovered that distribution of blood in the arteries depends on operational requirements of the tissues and organs, it is not determined by integrating mechanisms of neuroendocrine regulation. Problems of hemodynamics and microcirculation give rise to much discussion now because neurogenic hypophysis of cardiovascular disease development still has many supporters among medical profession.

[Diagnosis and choice of therapy of arterial hypertension].

The clinical concept of evolvement, chronisation and development of hypertensive disease is expounded in the light of recent basic research with reference to the influence of hypotensive (symptomatic) and pathogenetic (basal) therapy on its clinical features. The main stages of pathogenesis, risk of complications, and concomitant diseases are discussed. Analysis of main physiological mechanisms underlying regulation of hemodynamics is presented at different steps of formation of the cardiovascular system and angiogenesis from fetal life to the outset of involutional processes.

[Arterial hypertension and hypertensive disease (syndrome diagnosis and nosological diagnosis)].

Fundamental innovations in the study of the regulatory mechanisms of circulation in the past 20-30 years (evidence for the role of the endothelium in local hemodynamic control, the basic significance of the tissue (paracrine) link of the angiotensin mechanism of not only as a vasoconstrictor, but also a trigger of a slow pressor component that leads to resistance bed arterial remodeling) have required the concept of the pathogenesis of hypertensive disease (HD) (essential hypertension) to be reconsidered, confirmed its qualificational (nosological) isolation (by the criterion of the presence of an attributive functional and structural sign). The new refined and concrete information on the pathogenesis of HD and its associated cardiovascular disease has shown to give doctors reliable landmarks to optimize drug therapy: both symptomatic (to accelerate effective blood pressure control) and basic (to eliminate endothelial dysfunction and to restore remodeled arteries and microcirculation) therapies.

[Choice of treatment policy for hypertensive patients: its individualization, indications, and criteria].

Fundamental innovations in the study of the regulatory mechanisms of circulation in the past 20-30 years (evidence for the role of the endothelium in local hemodynamic control, the basic significance of the tissue link of the angiotensin mechanism (A-II) of not only as a vasoconstrictor, but also a trigger of a slow pressor component that remodels resistance bed arteries) have forced to revise the concept of the pathogenesis of hypertensive disease (HD) (essential hypertension) and confirmed its nosological isolation. The new refined and specified information on the pathogenesis of HD has shown to give doctors reliable landmarks to optimize drug therapy: 1) symptomatic for accelerated effective blood pressure lowering and 2) basic in order to eliminate endothelial dysfunction and to restore remodeled arteries and microcirculation.

[Metabolic support of the arterial wall and role of the vasa vasorum in health and in disease (analysis of clinical and experimental studies)].

A few papers recently published in foreign countries on atherogenesis, vascular atherosclerotic changes, metabolic support of arterial wall medial cells, and the role of the vasa vasorum in these processes are analyzed. Arguments are advanced in favor of that local hemodynamic factors and elevated blood pressure are a basis for the development of vascular atherosclerotic changes.

[Arterial hypertension syndrome as a maladaptation marker].

Hypertension epidemic in all developed countries is stipulated by incidence of primary hypertension. All prophylactic measures and pharmacotherapy are designed just for prevention and therapy of this hypertension form making up the majority of easy cases and unfavorable hypertension cases. The experience of western countries demonstrates the efficiency of purposeful population strategy in prophylaxis of hypertension and prevention of its complications in patients and in high risk groups with successful prevention of chronic hypodynamia, restriction of dietary salt, refusal of smoking and abuse of alcohol.