Аim: to assess the influence of the patient's psychotype on the degree of nighttime reduction in blood pressure (BP) to determine predictors of an unfavorable daily BP profile.Materials and methods. The study involved 80 patients with newly diagnosed or untreated arterial hypertension (AH), with various stages, severity, risk of developing cardiovascular complications, in the absence of concomitant severe somatic pathology, who independently consulted a local therapist. All patients underwent 24-hour blood pressure monitoring in the absence of antihypertensive therapy and the psychological profile was assessed using the SMOL  questionnaire.Results. The psychopathological profile of the examined AH patients corresponded to the social and psychological adaptation. Our analysis of the indices of   the averaged profile of the SMOL test, depending on the degree of reduction in nocturnal systolic blood pressure (between dipper and non-dipper profiles) and diastolic blood pressure (between dipper, non-dipper and extreme dipper patterns profiles) did not reveal statistically significant differences (p > 0,05). Patients with a riser daily blood pressure profile, due to the small size of the group, were not included in the comparative analysis. The average profile of SMOL of the examined patients was noted by an increase in indicators on the scales 1 – hypochondria and 3 – emotional lability.Conclusion. The variant of the daily blood pressure profile does not depend on the psychotype of the patient; it is likely that functional and structural changes that occur during the formation of hypertension affect the type of the degree of nighttime decrease in blood pressure.

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The article presents a clinical case of chronic rheumatic heart disease that was not diagnosed during patient’s lifetime because it had been looking like cardiac arrhythmias and heart failure with tricuspid valve disease. It also discusses pathogenetic substrates of chronic rheumatic heart disease and problems in disease diagnostics when it is accompanied by tricuspid valve lesion.

Красноярский государственный медицинский университет имени профессора В. ф. Войно-Ясенецкого, Красноярск 660022, Российская федерация Резюме. В обзоре представлены и систематизированы данные о применении статинов при остром коронарном синдроме. Приведены результаты масштабных клинических исследований гиполипидемической терапии статинами в том числе, проведенных в свете современных европейских рекомендаций по ведению больных с острым коронарным синдромом, включая оказание помощи с использованием эндоваскулярных методов реваскуляризации миокарда. Показано, что оптимальными сроками назначения липидснижающей терапии при остром коронарном синдроме являются первые часы развития заболевания и особенно важно назначение статинов перед чрезкожными коронарными вмешательствами. Отражена безопасность проведения липидснижающей терапии в том числе в высоких дозах. Обсуждаются вопросы о дозах, выборе статина при остром коронарном синдроме. Ключевые слова: острый коронарный синдром, ОКС, статины, гиполипидемическая терапия, острый инфаркт миокарда, дислипидемия. Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи. Для цитирования: цибульская НЮ, Харьков еИ, Петрова ММ. Гиполипидемическая терапия статинами при остром коронарном синдроме.Abstract. The review presents systematized data on the use of statins in acute coronary syndrome. It also shows the results of large-scale clinical studies of lipid-lowering therapy with statins, including the ones carried out in modern European guidelines for management of patients with acute coronary syndrome, including the use of endovascular myocardial revascularization. It has been shown that the optimal period for lipid-lowering therapy in acute coronary syndrome is the first hours of the disease development, and it is especially important to prescribe statins before percutaneous coronary interventions. The safety of lipid-lowering therapy, including high doses is reflected. Disputes about doses, statin choice in acute coronary syndrome are discussed.