Aim. Examination of knowledge of the basic provisions of clinical guidelines for the management of patients with arterial hypertension and finding out the readiness of doctors for the practical application of updated recommendationsMaterial and methods. Anonymous questionnaires of 306 doctors served as material for the study. The questionnaire consisted of two parts. The introductory part included questions that allow to find out the specialty, work experience, gender, age, and whether the respondent has cardiovascular risk factors. The main part of the questionnaire included 16 questions regarding provisions of the guidelines on the diagnosis and treatment of arterial hypertension in force at the time of the survey (2017/2018 academic year). Statistical processing of the results was carried out using the Microsoft Excel 2010 software package. Differences were regarded as significant at p<0.05.Results. The findings suggest that both therapists and cardiologists do not give due importance to the risk stratification of cardiovascular complications in patients with arterial hypertension and are not sufficiently aware of the possibilities and limitations of the use of combinations of antihypertensive drugs. Therapists worse than cardiologists know the main points of the clinical guidelines for the management of patients with arterial hypertension (target blood pressure levels during treatment [64.6% vs 87.7%, p<0.001], indications for combination antihypertensive therapy starting, the possibility of fixed dose combinations using [52.3% vs 83.9%, p<0.001]). A significant part of physicians (both cardiologists and therapists) adequately assess the antihypertensive treatment effectiveness, not enough frequent achievement of the target blood pressure level in their patients and is willing to provide more strict control of blood pressure.Conclusion. The results of the survey indicate the need of the active education of doctors in the management of patients with arterial hypertension. The most attention should be paid to the training of therapists and general practitioners on the cardiovascular complications risk stratification, the using of the antihypertensive drugs combinations use and methods to increase patient adherence to antihypertensive therapy.

Objective: Obesity is one of the additional risk factors for early development of atherosclerosis and cardiovascular complications in patients with hypertension. Von Willebrand factor (vWF) is a plasma glycoprotein which plays an important role in the thrombogenesis. On the other hand it is considered as a marker of the endothelial dysfunction. The objective of our study was to assess the level of vWF in patients with hypertension and early manifestations of coronary atherosclerosis depending on the presence of obesity. Design and method: 79 middle-age (49,88 ± 7,77) patients with hypertension and established coronary atherosclerosis (71 men and 8 women) were involved into study. According to the calculating body mass index (BMI), all subjects were divided into 2 groups: 22 obese people (BMI above 30 kg/m2) and 57 non-obese patients. In all patients we analyzed family history, smoking status, history of diabetes. The plasma lipid profile and vWF level were estimated using EIA kit (Uscn Life Science Inc., Cloud-Clone Corp., USA). Results: Both groups did not differ in the family history of cardiovascular disease, smoking status and diabetes. Though all patients received statins triglycerides levels were significantly higher in obese patients [95%CI: 1.50; 2.57] compared with patients in the other group [95% CI: 1.29; 1.70] (p < 0.05). Almost all but one obese patient had high levels of vWF [95% CI: 53.87; 72.38]. Among patients with a BMI below 30 kg/m2, normal values of vWF were detected in 21 patients [95% CI: 41.38; 52.76]. The groups significantly differed in the level of vWF, both when calculating the odds ratio (OR) using the Pearson chi-square criterion [OR: 5,6; p = 0.0035] and when comparing samples according to the Student's t-criterion (p < 0.005). Conclusions: Results of the study suggest enhanced endothelial dysfunction as one of the possible links between obesity and increased risk of cardiovascular complications in patients with hypertension.

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The paper discusses the aspects of using b-adrenoblockers in the treatment of patients with arterial hypertension (AH). It discusses the reasons why United Kingdom experts have excluded b-adrenoblockers from the list of first-line antihypertensive drugs. The place of b-adrenoblockers is defined among other antihypertensive agents according to the European and Russian guidelines for the management of hypertensive patients. The authors show indications for the use of different b-adrenoblockers in patients with AH and underline the need for an individual approach to choosing a b-adrenoblocker and the expediency of administering long-acting cardioselective drugs as agents having an optimal combination of their efficacy and safety.