Arterial hypertension is a major risk factor for cardiovascular disease, affecting a large proportion of the population worldwide. The study of the listed literature made it possible to assess the effectiveness and necessity of physical exercise in the treatment of hypertension syndrome, including various types of exercise, intensity, duration, and frequency, since drug treatment is not enough for successful therapy. To prevent and treat hypertension, a comprehensive approach is required, including aerobic exercise, which will lower blood pressure by dilating blood vessels.
Артериальная гипертензия (АГ) является основным фактором риска сердечно-сосудистых заболеваний, поражающих значительную часть населения во всем мире. При этом медикаментозного лечения часто бывает недостаточно для успешной терапии АГ. Изучение данных литературы по соответствующей теме позволило оценить эффективность разных физических упражнений в терапии АГ, их интенсивность, продолжительность и частоту. Показано, что для профилактики и лечения АГ необходим комплексный подход, включающий аэробные упражнения, которые позволят снизить артериальное давление.

Hypertension has become a central risk factor for the development of cardiovascular disease, underscoring the importance of its accurate diagnosis. Numerous studies have established a close relationship between elevated systolic (SBP) and diastolic (DBP) blood pressure and an increased risk of cardiovascular event (CVE). Traditionally, blood pressure (BP) measurements performed in clinical settings have been the main method for diagnosing and assessing hypertension. However, in recent years, it has been recognized that BP measurements obtained outside the clinical setting, using self-monitoring blood pressure (SMBP) and ambulatory blood pressure monitoring (ABPM), offer a more realistic perspective of patients\' daily lives and therefore provide more reliable results. Given the evolution of medical devices, diagnostic criteria, and the increasing relevance of certain components of ABPM in the prediction of adverse cardiovascular outcomes, a comprehensive update that is practical for daily clinical practice is required. The main objective of this article is to provide an updated review of ABPM, focusing on its importance in the evaluation of hypertension and its impact on public health in Colombia. In addition, it will discuss the implications of changes in diagnostic thresholds and provide concrete recommendations for the effective implementation of ABPM in clinical practice, allowing health professionals to make informed decisions and improve the care of their patients.

The global increase in dementia cases, driven by improved life expectancy and reduced elderly mortality rates, presents a significant public health challenge. Dementia, characterized by a gradual and irreversible decline in cognitive abilities, affects individuals aged 65 and older, disrupting lives and straining healthcare systems. Hypertension significantly influences dementia development. Research consistently links midlife hypertension to cognitive decline, mild cognitive impairment (MCI), and dementia, but findings in older adults vary. While some studies suggest that late-life hypertension accelerates cognitive decline and dementia risk, others propose a protective effect. The impact of hypertension on cognition varies across age groups, spanning from childhood to late life. High blood pressure during midlife and earlier life stages consistently predicts poorer cognitive outcomes. Executive function, attention, and motor speed are the cognitive domains most affected by hypertension, particularly in subcortical diseases. Memory impairments in hypertension-related dementias are complex, often overlapping with other causes. Understanding the inconsistent findings in older adults regarding hypertension, cognitive decline, and dementia risk requires comprehensive exploration of methodological and biological factors. Addressing hypertension and its management may hold the key to reducing the risk of cognitive decline and dementia, especially in midlife and earlier life stages.

The high prevalence of arterial hypertension and necessity for permanent monitoring of blood pressure requires implementation of new methods of interaction between patient and physician in order to optimize medical care. The purpose of the study was to describe and to evaluate functional possibilities of Russian-speaking mobile applications utilized in collecting blood pressure readings to monitor efficiency of arterial hypertension treatment. The study was carried out in June 2023 in three mobile application stores: Apple Store, Google Play and RuStore. The Russian-speaking applications applied to hypertension self-controlling were considered. For final analysis 45 mobile applications were selected out of 380 applications tested. The most common functions, besides fixing blood pressure levels, were ability of fixing pulse rate (n=41), weight (n=21), sugar level (n=10), blood oxygen saturation (n=8), cholesterol (n=6), rhythm disturbances (n=6) and body temperature (n=5). Additionally, applications made it possible to add tags (n=33), to view statistics (n=41) (including average blood pressure (n=8), pulse pressure (n=9), average daily blood pressure (n=6) and to compare data for different periods of time (n=6), to filter data by tags (n=17), to export statistics (n=32). The 6 applications also supported technology of wireless reception of blood pressure and emergency data. The educational information about blood pressure was enclosed in 17 applications and dietary advice in 12 applications. The content included basic information about blood pressure, treatment, diet, and physical activity. No clinical studies that proved efficiency or inefficiency of analyzed applications were found. None of descriptions comprised both involvement of physicians in development of application and use of clinical recommendations. The results demonstrated large choice of applications used in recording blood pressure with purpose of hypertension self-control. Besides, mobile applications contain various functions and their combinations that can help patient to control blood pressure more effectively. The physicians are to be aware of capabilities of mobile applications developed with purpose of monitoring health of patients.

The activity of the renin-angiotensin-aldosterone system is one of the main pathogenetic mechanisms underlying cardiovascular diseases at all stages of the cardiovascular continuum. This article discusses the role of telmisartan and azilsartan as the most powerful sartans in modern cardiology. Azilsartan and especially telmisartan have a significant organoprotection and are superior to other antihypertensive drugs in terms of lowering blood pressure. However, the effect of azilsartan on hard endpoints has not been studied while the efficacy of telmisartan on hard endpoints has been evaluated in plenty clinical trials including 3 large randomized clinical trials with several thousand patients. The article also presents calculations showing the better cost-effectiveness of telmisartan compared to azilsartan.
Активность ренин-ангиотензин-альдостероновой системы является одним из основных патогенетических механизмов, лежащих в основе сердечно-сосудистых заболеваний на всех этапах сердечно-сосудистого континуума. В данной статье рассматривается роль телмисартана и азилсартана как самых сильных сартанов по своему антигипертензивному эффекту в современной кардиологической практике. Азилсартан и в особенности телмисартан обладают выраженной органопротекцией и превосходят другие антигипертензивные средства в отношении снижения артериального давления. Однако влияние азилсартана на жесткие конечные точки не изучалось, в то время как эффективность телмисартана оценивалась во множестве клинических исследований, включая 3 крупных рандомизированных клинических исследования с участием нескольких тысяч пациентов. В статье также представлены расчеты, свидетельствующие об экономической эффективности телмисартана по сравнению с азилсартаном.

Oxidative DNA damage markers (8OHdG, comet assay, gammaH2AX) are becoming widely used in clinical cardiology research. To conduct this review of DNA damage in relation to hypertension in humans, we used databases (e.g. PubMed, Web of Science) to search for English-language publications up to June 30, 2022 and the terms: DNA damage, comet assay, gammaH2AX, 8OHdG, strand breaks, and arterial hypertension. Exclusion criteria were: children, absence of relevant controls, extra-arterial hypertensive issues, animal, cell lines. From a total of 79526, 15 human studies were selected. A total of 902 hypertensive patients (pts): (comet: N=418 pts; 8OHdG: N=484 pts) and 587 controls (comet: N=203; 8OHdG: N=384) were included. DNA damage was significantly higher in hypertensive pts than healthy controls (comet 26.6±11.0 vs 11.7±4.07 arbitrary units /A.U./; P<0.05 and=\"\" 8ohdg=\"\" 13=\"\" 1=\"\" 4=\"\" 12=\"\" vs=\"\" 6=\"\" 97=\"\" 2=\"\" 67=\"\" ng=\"\" mg=\"\" creatinine=\"\" i=\"\"> P<0.05) confirmed with meta-analysis for both. Greater DNA damage was observed in more adverse cases (concentric cardiac hypertrophy 43.4±15.4 vs 15.6±5.5; sustained/untreated hypertension 31.4±12.1 vs 14.2±5/35.0±5.0 vs 25.0 ±5.0; non-dippers 39.2±15.5 vs 29.4±11.1 A.U.; elderly 14.9±4.5 vs 9.3±4.1 ng/mg creatinine; without carvedilol 9.1±4.2 vs 5.7±3.9; with coronary heart disease 0.5±0.1 vs 0.2±0.1 ng/mL) (P<0.05) confirmed with meta-analysis. DNA damage correlated strongly positively with serum glycosylated haemoglobin (r=0.670; P<0.05) and negatively with total antioxidant status (r=-0.670 to -0.933; P<0.05). This is the first systematic review with meta-analysis showing that oxidative DNA damage was increased in humans with arterial hypertension compared to controls.

BACKGROUND: There is a hypothesis of an association between diverticulosis and metabolic syndrome (MS) or its components, but data on this topic are inconsistent, and a systematic review has not been performed. We conducted a systematic review to investigate the possible association between cardiometabolic risk factors and diverticulosis.
METHODS: A systematic literature search was conducted via PubMed, Cochrane Library, and Web of Science in December 2022 to collect the necessary data. Studies that examined the association between MS or individual metabolic factors and asymptomatic diverticulosis were included in the review.
RESULTS: Of the potentially relevant articles identified via PubMed (477), Cochrane Library (224), and Web of Science (296), 29 articles met the inclusion criteria and were used for this work. These studies were assessed for study quality using GRADE. Overall, 6 studies were rated as \"very low,\" 19 studies as \"low,\" and 4 studies as \"moderate.\" The data suggest an association between arterial hypertension, obesity, and fatty liver disease in younger patients and diverticulosis. Patient age appears to play an important role in diverticular formation. Data on diabetes mellitus is inconclusive and may require further investigation depending on the location of the diverticula.
CONCLUSIONS: Based on the synthesized data, there is an association between arterial hypertension, obesity, and fatty liver disease in younger patients. The formation of diverticula seems to be influenced by age and genetic factors. The study suggests a connection with cardiometabolic risk factors. To gain a better understanding of the role of metabolic risk factors in asymptomatic diverticulosis, targeted studies are necessary based on these findings.

Chronic kidney disease (CKD) remains a pathologic entity with constantly rising incidence and high rates of morbidity and mortality, which are associated with serious cardiovascular complications. Moreover, the incidence of end-stage renal disease tends to increase. The epidemiological trends of CKD warrant the development of novel therapeutic approaches aiming to prevent its development or retard its progression through the control of major risk factors: type 2 diabetes mellitus, arterial hypertension, and dyslipidemia. Contemporary therapeutics such as sodium-glucose cotransporter-2 inhibitors and second-generation mineralocorticoid receptor antagonists are utilized in this direction. Additionally, experimental and clinical studies present novel drug categories that could be employed in managing CKD, such as aldosterone synthesis inhibitors or activators guanylate cyclase, while the role of melatonin should be further tested in the clinical setting. Finally, in this patient population, the use of hypolipidemic agents may provide incremental benefits.

暂无摘要。

Many studies have been conducted confirming the effect of uric acid (UA) on kidney function. It is obvious that there is a relationship between the effect of UA not only on kidney function, but also on the cardiovascular system, increasing cardiovascular risk. The review article provides basic information about the pathogenesis, principles and features of prescribing therapy to patients with chronic kidney disease (CKD) and cardiovascular disease. A lot of data currently indicates that hyperuricemia, both with and without crystal deposition, is associated with high cardiovascular risk and decreased kidney function. A number of studies and meta-analyses indicate that urate-reducing therapy prevents and slows down the decline in kidney function in patients with CKD, many of whom suffer from cardiovascular diseases or at least have several risk factors. Despite the fact that currently the guidelines for the treatment of CKD do not include a recommendation for the start of urate-lowering therapy, a large amount of data has been accumulated on the potential benefits of such treatment even in the absence of a diagnosis of gout. The preferred group of drugs for this group of patients are xanthine oxidase inhibitors, and for patients with eGFR below 30 ml/min/1.73 m2, it seems that allopurinol currently has larger evidence base for the efficacy and safety of prescribing.
Проведено множество исследований, подтверждающих влияние мочевой кислоты на функцию почек. Очевидно, что существует взаимосвязь между влиянием мочевой кислоты не только на функцию почек, но и на сердечно-сосудистую систему и повышение сердечно-сосудистого риска. В обзоре представлены основные сведения о патогенезе, принципах и особенностях назначения терапии пациентам с хронической болезнью почек (ХБП) и сердечно-сосудистой патологией. Много сведений в настоящее время указывают на то, что гиперурикемия, как с отложением кристаллов, так и без него, ассоциирована с высоким сердечно-сосудистым риском и снижением функции почек. Ряд исследований и метаанализов свидетельствует о том, что уратснижающая терапия предотвращает и замедляет снижение функции почек у пациентов с ХБП, многие из которых страдают сердечно-сосудистыми заболеваниями или как минимум имеют несколько факторов риска. Несмотря на то, что в настоящее время в рекомендации по лечению ХБП не включена рекомендация по назначению уратснижающей терапии, накоплено большое количество данных о потенциальной пользе такого лечения даже в отсутствие диагноза подагры. Предпочтительной группой препаратов для этой группы пациентов являются ингибиторы ксантиноксидазы, а для пациентов с расчетной скоростью клубочковой фильтрации ниже 30 мл/мин/1,73 м2, по-видимому, аллопуринол в настоящее время имеет большую доказательную базу по эффективности и безопасности назначения.