Metabolic syndrome (MS) has recently gained more clinical attention due to its increasing prevalence and association with adverse prognosis. One of the main pathological features of MS is endothelial dysfunction. It plays a key role in the development of cardiovascular MS complications. Therefore, effective therapy aimed at the normalization of endothelial function should be a part of pathogenetic management of MS patients.

Recently, the clinicians’ attention has been driven to metabolic syndrome (MS), due to increasing prevalence and adverse prognosis of MS. The goal of the treatment of any chronic disease is the achievement of adequate therapeutic compliance which, in turn, is determined by motivational status of both clinicians and patients. The associations between clinicians’ motivation for long-term treatment, their knowledge levels, and the readiness to apply this knowledge in practice, on one hand, and the achievement of chronic disease compensation in patients, on the other hand, deserve further investigation.Aim. To analyse the readiness of primary care clinicians for the treatment of MS patients. The specific objective was to assess the district therapeutists’ knowledge, skills, and readiness to implement them in clinical practice while treating MS patients.Material and methods. The study included district therapeutists working at Moscow City polyclinics. In 2011-2013, the participants took continuous medical education courses at the Therapy Department No. 2, Post-diploma Medical Education Faculty, Moscow State Medico-Stomatological University. The doctors’ knowledge and skills were assessed in a questionnaire survey.Conclusion. The results obtained demonstrate inadequate readiness of district therapeutists for the treatment of MS patients.

The influence of plasmasorbtion on vasodilatation activity of blood vessels in 85 patients with chronic kidney disease compared with therapy by inhibitors of angiothensine-converting enzyme was studied. It is proved the efficiency of plasmasorbtion on normalization of endothelinum-dependent vasodilatation in 74% patients and by lowing concentration of endothelinum-1 on 59±7,9% by the end of first month of trial. We noticed that therapy with inhibitors of angiohtensine-converting enzyme allowed to reach that level of endothelinum-1 only by the 6th month of trial. Normalization of endothelium functions can afford to decrease the level of daily proteinuria (p<0,05) and to increase the speed of glomerular filtration within 1 year by 7,6±1,5 ml/min in patients with I-II stage of chronic kidney disease and by 2,2±0,6 ml/min in patients with III-IV stage of chronic kidney disease.

The paper focuses on the justification for preferential administration of antihypertensive combination therapy. Pharmacotherapeutic features of starting the treatment with a combination of angiotensin-converting enzyme inhibitors (ACEI) and calcium antagonists (AC) are reviewed. The authors also present the latest evidence on the ACEI/AC combination effects on such vascular parameters as microcirculation and endothelial dysfunction.

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