Goal. The study of the clinical efficacy of combined use of systematic physical training (PT) and a fixed combination of a blocker of receptors for angiotensin II (ARB), valsartanum (Val) to dihydropyridine calcium antagonist (AA) with amlodipine (AML), appointed as part of standard therapy for smokers in patients with cardio-pulmonary pathology outpatient (III) stage of rehabilitation. Material. The study included 30 men aged 40 to 65 years. All patients were treated with statins, aspirin, .-blockers, selective and systematic FT performed 3 times a week for 4 months (duration of the training - 60 minutes with a period of moderate intensity training load of 50-60% of the threshold power cycling). After randomization, patients were divided into two groups: Group 1 (n=12) received additional angiotensin converting enzyme inhibitors (ACEI) and 2nd (n=18) - the combined preparation Exforge ® (AML 5-10 mg/Val 60 mg). Study duration - 4 months. Methods. In a study conducted clinical examination, bicycle stress test (VEM-test), echocardiography (echocardiography), ambulatory blood pressure monitoring (ABPM), spirometry, determination of concentrations of lipids and lipoproteins, glucose, fibrinogen, uric acid, creatinine, a calculation of glomerular filtration rate by MDRD. They used questionnaires: Hospital Anxiety and Depression Scale (HADS), St George's Hospital (SGRQ) and quality of life (QOL) SF-36. Results. Against the background of the FT, combined with taking an ACE inhibitor or a fixed combination of AML/Val, reduced the number of smoked cigarettes at 20.8±5.2 pieces (

Goal. The pilot project to organize or conduct performance improvement of existing structural units in specific hospitals (LU) Russia to provide rehabilitative care for patients with cardiovascular diseases in three stages under the current "Procedure for the provision of medical care for patients in medical rehabilitation", to introduce in practice these units tested scientifically sound approaches, forms and methods of cardio-rehabilitation, and try to create some patients routing algorithm. Material and methods. The pilot project includes 17 of the medical institutions of 13 regions of Russian Federation. Single special cards that allow to evaluate the appropriate order on the medical rehabilitation provided rehabilitation assistance to cardiac patients, a multidisciplinary team involved in the provision of rehabilitation assistance, staffing and equipping MI To analyze the effectiveness of organizational models in cardiorehabilitation MI have been developed. Special cards consisted of three sections, each of which allows you to evaluate the effectiveness of each of the three stages cardiorehabilitation: Stage I - unit intensive care unit (BRIT), and a specialized cardiology department; Stage II - stationary cardiorehabilitation department; Stage III - patient department cardiorehabilitation. The article presents the results of a three-year analysis from January 2013 to December 2015. Results. The pilot project was organized with the cardiorehabilitational help stage I in 10 DR, II stage - a 10-LU and Phase III - 7 DR. By 2015, almost all of Latvia to provide assistance in cardiorehabilitational area, multidisciplinary teams consisting of a cardiologist, cardiologist, rehabilitator, medical physical culture (physical therapy) specialist, physical therapy instructor-methodologist, psychotherapist, clinical psychologist, physiotherapist were formed. They were provided and equipped with facilities to practice physical therapy, room for educational schools. Home rehabilitation process BRIT has reduced the patient's stay in the bed of 0.7 days (2013 to 2015) and for 1 day in the cardiology department. On average, 67% of patients with acute myocardial infarction (AMI) were translated into Phase II cardiorehabilitaяtion in which they have become actively involved in the physical rehabilitation program, which is based on a classic exercise therapy, dosage walking in the room, physical training on simulators. Each MI educational schools were organized for patients actively pursued discussions with the relatives. Special complexity of the project has caused the organization phase III cardiorehabilitation. The project is currently ongoing. Conclusion. The analysis of the organization of a three-stage kardioreabilitatsionnoy care system with AMI patients considering the use of staffing, equipment and methodology, according to the current normative law, showed a significant increase in recreational activities created by multidisciplinary teams in all three stages of cardio-rehabilitation, increasing the number of used rehabilitation methods and improve the quality of their performance, as well as demonstrated safety of the proposed principles of physical rehabilitation, according to Russian clinical guidelines "Acute myocardial infarction with ST-segment elevation ECG: rehabilitation and secondary prevention", in the framework of the proposed organizational models cardiorehabilitation.

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Goal. Description of the influence of systematic phisical training (PT) on some indicators of physical performance (Fed) and the assessment of daily locomotor activity and psychological status of patients after myocardial infarction and were followed for 16 years. Material and methods. We observed 11 patients (9 men and 2 women) who after acute myocardial infarction (AMI) have participated in a one-year rehabilitation program, the basis of which amounted to the controlled PT of medium intensity (50-60%). Subsequently, patients continued PT program in hospital and in the home environment (observation of patients was 16 years). Programs of systematic PT were performed in a hospital, carried out with a small break in 2014-2015. Patients are constantly trained (ie the period of continuous PT amounted to 2 years), while a program of home exercises, patients try to perform consistently. They all underwent clinical examination, had a load test performed on a cycle ergometer protocol submaximal loading, questionnaires were evaluated by physical activity, level of subjective control, anxiety and depression and adherence to therapy estimated. Results. Blood pressure (BP) in patients were stable: in 2014 (prior to the beginning of organized PT) systolic blood pressure (SBP) was 127.9±15.2 mm Hg and diastolic blood pressure (DBP) - 74±6.3 mm Hg. In 2 years (2015) after the resumption of organized PT SBP decreased slightly to 121.2±7.0 mm Hg (p0.05), ie, 16 years. In 2015, when compared with the 1999 peak of PE decreased SBP by 4.6% (p

The goal lies in the study of amlodipine effects on levels of blood pressure (BP), hypertensive reaction under isometric exercise, lipid and carbohydrate metabolism, platelet hemostasis, quality of life (QoL) and psychological status in patients with arterial hypertension (AH), obese abdominal type. Material and methods. The study included 30 patients with hypertension of the 1st and 2 nd degree in age from 37 to 72 years (mean age 56.6±7.9 years) with abdominal obesity type. After a 2-week period "cleanse" of patients, amlodipine was administered at an initial dose of 5 mg, with an increase up to 2 weeks in the absence of 10 mg of achieving target blood pressure (less than 140/90 mm Hg). The total duration of treatment took 6 weeks. In a study conducted, the clinical examination and ambulatory BP monitoring were also included, and a manual isometric test was taken, to determine the concentration of lipids and lipoproteins, glucose and insulin platelet aggregation (spontaneous and under the influence of adenosine acid) was evaluated, as well as adrenaline in different concentrations. The questionnaires on quality of life, Hospital Anxiety and Depression Scale were used as well. Results. Against the background of 6 weeks of therapy with amlodipine, a decrease in blood pressure levels, as measured by the patient in a sitting position (21.7±8.2/12.3±4.6 mm Hg, p