Introduction and purpose. The article presents data on the obesity and endothelial dysfunction, on influence of smoking on the developing of endothelial dysfunction. Material and methods. Examined 108 patients (90 women and 18 men) with obesity aged 45 to 65 years old (middle age 54.62±0.43) with different degrees of obesity. Vasomotor endothelial function was evaluated by the method of Celermajer et al. Analyzed early markers of endothelial dysfunction in patients with metabolic syndrome. Statistical processing of the data using a nonparametric Wilcoxon-Konovalov and Mann-Whitney. Conclusions. Based on the study preliminary conclusions can be made of the importance of identifying early markers of endothelial dysfunction in these patients and how smoking influences on developing of vascular pathology in patients with obesity.

Clopidogrel is the most widely used P2Y12 inhibitor, which is administered for secondary prevention of atherothrombotic events in patients with cardiovascular disease after myocardial infarction and coronary stenting. Given the complexity of the clopidogrel metabolism and variety of potential drug-drug interactions, the issue of individual variability of its antiplatelet effects is of paramount concern. Another issue of clinical relevance is related to so-called "smoker's paradox". This phenomenon implies that in some patients smoking is associated with increased antiplatelet potency of clopidogrel. In this review, we analyze recent international data on the features of pharmacokinetics and pharmacodynamics of clopidogrel, plausible mechanisms of the "smoker's paradox" and its clinical significance in patients with coronary artery disease. Comparative efficacy of available P2Y12 inhibitors and possible implications of smoking are considered. Pharmacogenetic aspects and the issues of personalized antiplatelet therapy are discussed.

The aim of our study was to evaluate whether abnormal endothelial function is present in patients with arterial hypertension. Endothelial function was assessed by measuring flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation of the brachial artery using high-resolution ultrasound. In the group of subjects with arterial hypertension endothelial function was significantly impaired (FMD 9,26%), whereas nitroglycerin-mediated dilatation was normal.