In a group of 32 patients with combined ischemic heart disease (IHD) and arterial hypertension (AH) we studied dynamics of parameters of blood pressure and ECG 24-hour monitoring, as well as ultrasound structural and functional parameters of left and right ventricles during 3-month therapy with fixed dose combination of perindopril arginine (10.0 mg) and amlodipine (5.0 mg). The obtained results demonstrated significant positive effect of this combination on the geometry, structure and diastolic function of both left and right ventricles, as well as confirmed its high antiischemic and antihypertensive effects.

A study of daily blood pressure (BP) dynamics, functional endothelial condition at hypertensive patients in combination with tuberculosis of various localization and estimation of an opportunity of correction of the revealed disturbances during 12-week therapy by the fixed combination of perindopril and indapamide - noliprel-forte (Servier, France) were performed. During research more expressed endothelial dysfunction at hypertensive patients, proceeding on a background of tubercular process in comparison with patients with isolated arterial hypertension was revealed. Therapy by noliprel-forte provided the reliable 24-hour control of BP level, which was accompanied by endothelial function normalization that was shown by improvement of a endothelium-dependent vasodilatation and decrease of a von Willebrand factor level. .

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Comorbid patients with atrial fibrillation, diabetes mellitus and chronic kidney disease are at high risk of stroke. The direct oral anticoagulants are indicated for them. The choice of a drug should be based on the results of randomized clinical trials, in which the patients profile corresponds to that in the real Russian clinical practice as much as possible. Taking into account the peculiarities of comorbidity in this category of patients, the requirements for their protection should be considered comprehensively. Along with the prevention of thromboembolic complications, it is necessary that the selected direct oral anticoagulant provides a reduction in the risk of cardiovascular complications, which are typical of diabetes mellitus, and slows down the progression of renal filtration function decline. Rivaroxaban may meet these requirements; its use has significant advantage in high adherence to therapy.