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Aim. To assess the influence of addition of nicorandil on long-term cardiovascular complications in patients with chronic coronary artery disease (CAD) in the framework of a prospective observational study.Material and methods. Prospective observational multicenter NIKEA study included 590 patients with stable CAD. All patients were recommended to add nicorandil to their baseline therapy. After 21 months, 547 telephone contacts were made, the life status of 524 people was specified, 23 patients were lost to follow-up. The following complications were registered: death from any cause; non-fatal myocardial infarction (MI); non-fatal stroke; urgent myocardial revascularization; hospitalization due to deterioration of CAD, chronic heart failure (CHF) or atrial fibrillation (AF). In 479 patients, a telephone survey was performed to identify adherence (persistence) to nicorandil– i.e. to verify the continuing the treatment for the prescribed duration.Results. During the follow-up period, 15 deaths were recorded, the causes of which were as follows: 3 CAD (2 MI, 1 left ventricular aneurysm), 1 pulmonary embolism, 2 CHF; 1 stroke, 1 oncology, 1 bilateral pneumonia. In the remaining 6 cases, the causes of death were not known. Cardiovascular (CV) complications were MI (8 cases in 7 patients, 1 patient had 2 MI in the follow-up period, 3 patients from this group died), stroke in 6 patients (7 cases, 1 patient had 2 strokes, 1 patient died). Urgent percutaneous coronary intervention was performed in 3 patients (in 2 patients due to acute MI, in 1 patient due to unstable angina). During the observation period, 21 people were urgently hospitalized due to deterioration of clinical condition. According to the results of a medical survey, by the end of the follow-up period, 237 people were not adherent to prescribed nicorandil, and 242 patients took the recommended medication (adherent patients). The main cardiovascular complications and death from any cause (р<0.001) as well as the number of urgent hospitalizations (р=0.017) were significantly more common in non-adherent to nicorandil patients in comparison with adherent patients.Conclusion. The overall rate of CAD complications in NIKEA study was typical for patients with stable CAD receiving contemporary medical therapy. Addition of nicorandil significantly reduced the rate of CV complications in adherent patients in comparison with non-adherent patients.

Цель. Оценить частоту неблагоприятных исходов и вклад основных факторов риска в их развитие в рамках проспективного исследования. Материал и методы. Исследование проводилось как проспективное длительное исследование с периодом наблюдения 36 мес. Выборка в исследование МЕРИДИАН-РО формировалась из городского и сельского населения. Было включено 1622 человека в возрасте 25-64 лет. Отклик на исследование составил 86,1%. Наблюдение за обследованными лицами и сбор конечных точек продолжались в течение 36 мес. За конечные точки были приняты: смерть от любых причин, ишемический инсульт, инфаркт миокарда, реваскуляризация коронарных артерий. Результаты. При изучении взаимосвязи между различными факторами риска и исходами было выявлено, что оказывали значимое влияние на комбинированную конечную точку (смерть от любых причин + нефатальный ишемический инсульт + нефатальный инфаркт миокарда):

In clinical practice, quite often the practitioner faces difficulties in correcting arterial pressure in patients with arterial hypertension. Patients mostly for various reasons prefer to be treated with generic drugs, sometimes to the detriment of the effectiveness of treatment. The regional study conducted by us clearly showed the presence of additional possibilities of the original drug Prestans (Servier, France) in reducing blood pressure compared to equivalent dosages of generic fixed combinations.

Aim. To study the association of blood pressure (BP) and hypertension (HTN) with salt intake estimated by the survey and the urinary Na+ concentration among men and women 25-64 years old, examined within the ESSE-RF and ESSE-RF-2 studies.Material and methods. Representative samples of the Russian population aged 25-64 years were examined. At the first phase in 2012-2014, 21,888 people (men — 38,2%) were included, and at the second phase in 2017 — 6,714 people (men — 44,7%). The response rate was 80%. We used standard questionnaire. Adding more salt and the consumption of salted foods (sausages, deli meats, and pickled foods) in the criteria “daily or almost daily” was considered excess salt intake (ESI). BP measurement was carried out in a sitting position on the right hand. BP was measured twice with an interval of about 2-3 minutes. HTN was diagnosed at a systolic BP (SBP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg, or in case of antihypertensive therapy. In ESSE-RF-2, an analysis of the morning urine was additionally performed. Na+ was determined using the EX-Ds ion-selective electrolyte analyzer. All participants were stratified by the quintiles of urine sodium level. Data analysis was performed using the software package R 3.6.1. The models of linear and logistic regression were used. The differences were considered at p<0,05.Results. The average level of SBP significantly increases with an increase in Na+ in urine: 1,04 (0,60-1,48) mm Hg for the quintile of sodium distribution (p<0,001), the odds of HTN increases by 1,11 (1,05-1,17) times for the quintile (p<0,001). Questionnaire components of ESI are also significantly related to urinary Na+ levels. The consumption of sausages and deli meats has the greatest effect, causing an increase in the average Na+ level by 11,59 (7,06-16,12) mmol/l (p<0,001). The applied point scale is significantly related to urine sodium level and predicts HTN no worse than Na+ in the urine (p=0,15 for the difference hypothesis). One point on the scale increases the Na+ level by an average of 7,51 (5,01-10,02) mmol/l, SBP by an average of 0,74 (0,41-1,07) mm Hg and the odds of HTN by 1,1 (1,06-1,15) times (p<0,001 for all).Conclusion. In the pattern of ESI components, processed meat and sausage products take first place in terms of association strength with urine sodium. The questionnaire used to assess the proportion of people with ESI can be recommended for assessing this risk factor during screening. ESI detected by the questionnaire is associated with elevated BP and urinary Na+ values.