Relevance. Non-alcoholic fatty liver disease (NAFLD) is a multidisciplinary problem and occupies a significant place among chronic non-communicable diseases (CNCDs). The main causes of death from this nosology are cardiovascular pathology and neoplasms. This article discusses the main problems of underestimation of diagnosis in patients with high cardiovascular risk of NAFLD. In particular, attention is paid to the risks of developing hepatocellular carcinoma without previous cirrhosis. The aim of the study was to describe a typical portrait of a patient with a very high cardiovascular risk (CVR) with NAFLD and the features of the prevention of hepatocellular carcinoma (HC) in this category of patients. Research materials. The case history of a patient with stage 3 arterial hypertension, functional class II (FC) angina pectoris, postinfarction cardiosclerosis in combination with NAFLD in the stage of liver steatosis, stage 1 obesity, and impaired carbohydrate tolerance is presented. Results. Against the background of corrected antihypertensive therapy, blood pressure and heart rate returned to normal. The level of transaminases approached the reference values, there was a tendency to reduce total cholesterol, low density lipoproteins, triglycerides. According to volumetric sphygmography, vascular age began to approach the passport age, the augmentation index became within negative values, the ankle-brachial index remained unchanged, and an increase in endothelial function was observed. Conclusion. This clinical case provides an example of successful treatment of NAFLD and dyslipidaemia in a patient with very high CV risk. With this in mind, it is necessary to timely use drugs that directly affect the stages of the formation and progression of NAFLD, which should be actively prescribed for the prevention of GC.

Purpose. The work is devoted to study the effects of antihypertensive, lipid-lowering and metabolic therapy in office and the average hemodynamic parameters, the parameters of central pressure in the aorta, vascular wall stiffness and quality of life in patients with CKD stage 3 in combination with arterial hypertension of 1-2 degrees, and without it. Materials and methods. Were examined patients with arterial hypertension of 1-2 degrees and CKD stage 3. Measured hemodynamic parameters with the help of a daily BP monitor “BPLab”. The quality of life of patients was assessed by the questionnaire MOS SF36. Results. The greatest changes in the indicators of central hemodynamics and vascular stiffness were noted in the group of patients with comorbidity. Conclusion. The combination of antihypertensive therapy (losartan and diltiazem) with meldonium and rosuvastatin significantly decreases indices of central and peripheral hemodynamics and vascular stiffness. Add meldonium part of therapy significantly improves the quality of life of patients.

Mortality from cardiovascular and oncological diseases has remained at record highs for many years. Clinicians pay attention to the frequent combination of these two pathologies. Naturally, the question arises, what unites seemingly different diseases among themselves? Modern cancer therapy has allowed many people to achieve a cure or a stable remission, but at the same time led to the appearance of cardiac pathology. The relationship between the development of cardiotoxic events after antitumor therapy has been well studied, but undeservedly little time is allocated in real clinical practice to study vasculotoxicity in patients. This approach can be considered as the earliest predictor of damage to the microvasculature as a result of specific therapy. The analysis of groups of anticancer drugs that cause chronic heart failure and damage to the vascular endothelium to the greatest extent was carried out. The main approaches to risk stratification in cardio-oncological patients are considered. The principles used in the prevention and treatment of cardio- and vasculotoxicity have been studied.