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AIM: To study the structure of mortality not caused by coronavirus infection, in patients with polymorbid pathology during the period of self-isolation (lockdown). MATERIALS AND METHODS: Outpatient records of 2 423 patients with polymorbid pathology (841 males and 1 582 females, aged from 18 to 99 years) were examined. The mortality and its causes during three years including a period of lockdown were investigated. RESULTS: The overall mortality rate among patients with polymorbid pathology was 10.2% without differences in gender. The structure of the causes of death in patients with polymorbidity: cardiovascular diseases accounted for 50.8%, oncological diseases 21%, nervous system diseases 7.3%. During the lockdown, an increase in overall mortality by 34.3% was recorded (p 0.05), with an increase in the number of deaths of patients with cardiovascular diseases by 19.5% (p 0.05) (mostly patients with ischemic heart disease). CONCLUSION: An increase in the number of deceased patients with polymorbidity during the lockdown may be due to the limitation of physical activity, of the possibility of examination and consultation by profile specialists. Taking into account the vulnerability of this group of patients, there is an urgent need to develop preventive measures when the situation recurs.

Aim. To study the effectiveness and benefits of blood pressure (BP) remote monitoring in outpatients with hypertension.Material and methods. The study included 100 patients with a verified diagnosis of hypertension, who didn’t achieve target BP pressure levels. The patients measured their BP twice a day over 6 months with facilities with automatic data transmission over GSM-channel to a remote monitoring center. BP parameters were being transmitted online to the remote monitoring center, where they were being processed and transferred to the personal account planner (created by the Web interface based on the software and hardware complex) of the attending physician and operator of the remote monitoring center. It is important that doctor received information only on clinically significant measurement results, based on which he determined the urgency of contact with the patient and the further tactics of his management.Results. No malfunctions in the work of communication facilities, technical failures in the software and hardware complex were registered over the entire period of the study. After 6 months of the monitoring it was possible to achieve target BP levels less than 135/85 mm Hg in 70% of patients. The proportion of patients with a high level of normal BP increased from 10% to 19%, while the proportion of patients with grade 1 and 2 of hypertension decreased significantly (from 33% to 7% and from 54% to 3%, respectively). At the beginning of telemedicine monitoring 3% of patients had stage 3 of hypertension, at the end of the study – 1%.Conclusion. The technology of telemedicine monitoring has shown itself as a simple, affordable and reliable way of management of outpatients with hypertension in conditions of real clinical practice. It was possible to achieve BP levels less than 135/85 mm Hg in 70% of patients by the method of remote outpatient monitoring. BP remote monitoring changed fundamentally the decision-making strategy of the patients management: it was not the patient who independently determined the need for consultation with a medical professional, but the attending physician made a decision on the method and urgency of contact with the patient on the basis of the data of objective monitoring indicators.

Aim. To study possibilities of pharmaceutical correction of clinical laboratory parameters, of endothelial dysfunction and non-specific adaptation reserves in patients with metabolic syndrome (MS) through use of metformin. Materials and Methods. The three-month program involved 53 patients with MS rando-mized to two comparable groups. Patients of the control group were kept on individual low-calorie diet and practiced graduated exercises. Patients of the studied group, besides the mentioned program of modification of the lifestyle, took metformin. In all participants, anthropometric and clinical laboratory parameters were twice evaluated, total body composition, condition of vascular endothelium and non-specific adaptation reserves of an organism were analyzed. The extent of endothelial dysfunction was evaluated by the level of endothelin-1 and by parameters of photoplethysmographic examination, non-specific adaptation reserves by the method of analysis of the cardiac rhythm variability. Results. Metformin in complex with dietary therapy and physical exercises proved to be a safe medical drug for correction of components of MS and of endothelial dysfunction. Use of metformin in patients with MS in combination with dietary therapy and graduated physical exercises as compared to use of the program of modification of the lifestyle alone, leads to reduction in the body mass, waist circumference (in women) and of the total fat mass. Introduction of metformin into the program of complex therapy of patients with MS, provides more evident correction of the parameters of carbohydrate metabolism, reduction of endothelin-1 and stiffness index of the aortic wall, enhancement of parasympathetic regulation, than modification of the lifestyle alone. Conclusion. Use of metformin in the complex therapy of metabolic syndrome in comparison with the program of modification of the lifestyle, promotes a more significant reduction of the clinical laboratory parameters, of endothelial dysfunction and improves non-specific adaptation reserves of an organism.