[Uncontrolled Arterial Hypertension: Kidney, Neurohormonal Imbalance, and Approaches to Antihypertensive Drug Therapy].

Resistant and refractory arterial hypertensions are two distinct clinical phenotypes of uncontrolled arterial hypertension (AH), which differ in their sensitivity to antihypertensive drug therapy. The review presents data obtained in clinical studies devoted to elucidating the involvement of disorders of neurohormonal status and renal function in the formation of resistant and refractory arterial hypertension, to and the development of new approaches to increasing the effectiveness of antihypertensive therapy in these patient's populations. The results of these studies have shown that in patients with uncontrolled arterial hypertension, despite prolonged intake ≥ 3 antihypertensive drugs with different mechanisms of action, including a diuretic, excess sodium reabsorption persists in the distal segments of nephron due to increased aldosterone activity and sympathetic nervous system hyperactivity.

[Nephroprotective properties of third-generation beta-adrenoblockers].

Experimental and clinical data on the nephroprotector properties of third-generation beta-adrenoblockers nebivolol and carvedilol are reviewed. These properties are related to the antihypertensive effect and ability of drugs to suppress oxidative stress in glomerules, proximal renal tubules, and surrounding interstitial tissue.

[Activity of the key glycolysis enzymes of the heart during emotional stress and myocardial necrosis induced after exposure to stress].

Activities of hexokinase, phosphofructokinase and pyruvate kinase were studied in rat heart after emotional-painful stress and development of myocardium necrosis. The stress caused an activation of hexokinase and phosphofructokinase within 2 and 7 days, activity of pyruvate kinase was not altered. In myocardium necrosis developed after emotional-painful stress activity of phosphofructokinase was decreased within 2 days as compared with the animals, myocardial necrosis of which was produces using the routine procedures.

[Glycogen metabolism in the brain and heart in ischemic myocardial necrosis and stress].

It is established that the emotional stress preceding the acute development of ischemic necrosis of the myocardium is the most important condition of the glycogen metabolism disturbance in the central nervous and cardiovascular systems. The most considerable changes in the glycogen metabolism are detected in the heart.