Dynamics of heart failure and left ventricle functions manifestations in patients with myocardial infarction after stenting of infarct-related coronary artery in combination with manual thromboaspiration
D.S. Maznev, I.A. Leonova, S.A. Boldueva 83
Features of the course of arterial hypertension in men depending on the psychosomatic status of the patient
ENVIRONMENTAL AND MEDICAL FACTORS OF INCREASEDINCIDECE RATES FROMUROTHELIAL CANCER IN RESIDENTS OF THE REPUBLIC OF CRIMEA V.Yu. Startsev1, I.Yu.Akinshevich2, I.N.Dylenok2, T.R. Dzhemilev2
1St. Petersburg State Pediatric Medical University, Russia, 197376, Saint-Petersburg, Akademika Pavlova Street, 12 2 Crimean Republican Clinical Oncological Dispensary named by V.M. Efetov,Russia, 295023,Simferopol, Bespalova Street, 49А
Abstract Introduction. Urothelial cancer is a malignant tumor of the transitional epithelium of the urinary system organs, that might be associated with the exposure to environmental risk factors. The aim of the study was to evaluate the results of specialized medical care for residents of the Republic of Crimea with urothelial cancer, based on medical and statistical andenvironmental health information of the studied area. Materials and methods. The analysis of medical and statistical indicators characterizing the effectiveness of medical care for residents of the Republic of Crimeawith the urothelial carcinoma during 2005-2018was performed. The data on the environmental health in the Republic of Crimea was reviewed. Results. The main medical and statistical dataare presented according to the state statistical reports: incidence rates, number of patients and totalpopulation, mortality rates, one-year mortality in patients with urinary tract tumorsof the main localizations, including urothelial cancer. An increase in “rough” incidence rates per 100,000 (from 10.2 to 14.6), mortality (from 4.1 to 4.7) and an increase in the contingent of urothelial cancerpatients, while reducing the level of one-year mortality (from 22.2% to 13,1%) in patients with this cancer. Temporal trendof indicators during 2005-2018 was compared with establishing the Department of UrologicOncology in the Regional Oncology Center in 2016. It was assessedthe environmental risk factors ( anthropogenic, natural) and the level of medical aid t that could potentially affect the development of urothelial canceramong residents of the Republic of Crimea. Conclusion. The potential impact of natural-caused and medical factors on the unfavorable trend of morbidity and mortality from urothelial canceramong the citizens of the Republic of Crimea is ambiguous and requires further study. Due to the increase of the mortality ratesin residents of the Republic of Crimea from urothelial cancerin 2005-2013, it is advisable to continue the study on the possibilities of development and implementation the state programfocused on prevention and monitoringurothelial cancer among the population of the Republic of Crimea. Keywords: urothelial cancer, risk factors, screening for bladder cancer, cancerprevention, Republic of Crimea
CHARACTERISTICS OF FREQUENCY OF BRONCHIAL ASTHMA IN CHILDREN IN URBAN AND RURAL AREAS OF THE BELGOROD REGION N.M.Agarkov1, A.V.Poshivailova1, V.D.Lutsenko2 1 Southwest state University, Russia, 305040, Kursk, 50 years of October street,94 2 Belgorod state national research University, Russia, 308015, Belgorod, Pobedy street, 85 Abstract Introduction. Asthma is one of the most common chronic condition samong children of different countries, including Russia. However, there are still no comparative studies on the bronchial asthma incidence in children in urban and rural areas. The aim of the study was to analyze the bronchial asthma incidence in children in urban and rural areas of the Belgorod region. Material and methods. According to the official statistics, the primary and general morbidity of childhood bronchial asthma in the cities and rural areas of the Belgorod region for 2012-2017 was studied by a continuous retrospective method. Result. The primary incidence of bronchial asthma in children is almost the same in urban and rural areas (P>0.05). However, the overall incidence of bronchial asthma in the children's population is significantly higher in the region cities. There is a direct correlation between the primary and general incidence of asthma in children and the availability of pediatricians in urban and rural areas. Key words: bronchial asthma, morbidity, prevalence, children
CHANGES IN SMOKING BEHAVIOR AMONG POPULATION AND EVALUATION OF THE IMPACT OF THE ANTI-SMOKING LAW ON TOBACCO EPIDEMIC
V.F. Levshin, N.I. Slepchenko N.N. Blokhin Russian Cancer Research Center, Russia, 115478, Moscow, Kashirskoe avenue, 24, Abstract Introduction. Regular observational studies are necessary to successfully combat the tobaccoepidemic allowing to objectively assess the dynamics in the smoking behavior indicators of the population and the measurement effectiveness of the tobacco epidemic prevention. The aim of the study was to analyze the main characteristics of smoking behavior among the population and their changes before and after the adoption of the anti-smoking law. Material and methods. The population–based survey of Moscow adult citizens was conducted in 2017 – 2018, comprising 1020 people aged 18 – 81 years (meanage was 51, 71+14,27). The unified questionnaire on smoking behavior and history was used by qualified interviewers. In order to study the dynamics of smoking behavior among the population current smoking behavior indicators were compared with the result of previous similar surveys conducted before 2013, when the anti-smoking law was approved. Changes in smoking indicators were stratified by sex and age. Results. The percentage of current male smokers was 54, 2% (95% CI: 49% - 59%) and 27,3% of female smokers (95% CI: 24% - 31%), the highest percentage of malesmokers was in the middle age group- 30-49 years, - 65,7% (95% CI: 57% -75%) among female smokers in the young group up to 30 years – 45.2% (95% CI: 30% - 60%) Among the male smokers, smoking more than 20 cigarettes per day the highest percentage was observed in the age group over 49 years - 26.6% (95% CI: 19% -34%), at the age 30-49 years – 19.7% (95% CI: 10-29%) and under 30 years – 0%. The historical comparison of smoking behavior indicators of the population obtained from the surveys of the population conducted before and after the adoption of the anti-smoking law revealed a significant decrease in the prevalence and intensity of smoking in later years.
Conclusion. Despite a slight reduction in tobacco consumption among the population, the smoking prevalence in Russia remains one of the highest in the world. Campaign against the tobacco epidemic requires a long-term complex of the anti-smoking measures aimed to prevent and to stop smoking, and to achieve the decrease in smoking prevalence among population. Keywords :smoking prevalence, smoking intensity, quitting smoking, dynamics of smoking behavior.
PREVENTION OF POST-INJECTION COMPLICATIONS USING THE INFOCENTER OPERATIONAL ADMINISTRATION UNIT DURING THE IMPLEMENTATION OF LEAN PRODUCTION IN A MEDICAL ORGANIZATION (SCIENTIFIC REVIEW)
A.A. Kurmangulov1, T.G. Zadorkina2, S.S. Mirakyan3, Yu.S. Reshetnikova1, N.S. Brynza1 1 Tyumen State Medical University,Russia,625023, Tyumen,Odessa street, 54 2Central Research Institute for Organization and Informatization of Medical Care, Russia, 127254, Moscow, Dobrolubovastreet, 11 3 City hospital № 2, Russia, 236034, Kaliningrad, Dzerzhynskogostreet, 147 Abstract
The development of a new model of a medical organization within the federal project “Development of a primary health care system” implies the introduction of general principles and individual tools and methods of lean manufacturing into the activities of medical institutions. One of the main methods of lean manufacturing is visualization, implemented in a federal project through the creation of information centers of a medical organization. The key indicator of the information center is the safety of medical activities. In the present literature review, the post-injection complications are considered as one of the indicators of patient safety. The results analysis of the original studies on this problem is carried out. It has been shown that the introduction of information centers with a qualitative and quantitative assessment of post-injection complications allowto predict and manage possible risks to patient safety. Timely indication and accounting of all the negative outcomes of pharmaceuticals and medical effects may allow to develop an effective system for the prevention of post-injection complications in medical organizations. Key words: visualization, lean production, infocenter, SQDCM, post-injection complications, prevention ASSESSMENT OF POTENTIAL HEALTH RISK OF DUE TO HAZARDOUS SUBSTANCES IN THE INDOOR AIR
N.O. Barnova, A.V. Mel'tser, A.V. Kiselev,I.Sh. Iakubova North-Western State Medical University named afterI.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnayastreet, 41 Abstract Introduction. Currently, there are no criteria for assessing the risk to health of those, who move into the long-awaited new housing, where unpleasant indoor odors are often observed. The aim of the study was to assess the potential risk for public health due to harmful substances contained in the indoor air migrating from building and finishing materials. Material and methods. It was used materials from 191 laboratory tests of indoor air in Saint- Petersburg and the Leningrad region to assess the risk. Indoor air research was conducted at the Hygiene and Epidemiology Centre in St. Petersburg from 2012 to 2018. It was used the methods of health risk assessment according to R 220.127.116.110-04 «Human Health Risk Assessment from Environmental Chemicals» and guidelines «Hygienic evaluation of the intensity of medico-ecological situation of different territories due to contamination by toxicants of the populationhabitat». Result. Accordingto the performed studies, ammonia could be considered as a priority pollutant for newly built buildings. The maximum detection risk for an obsessive smell, as well as, the probability of acute and chronic inhalation risk development, was determined in groups of premises from an excess concentration of ammonia from 5 maximum permissible concentration. Living in the newly built buildings, where the harmful impurities was detected in the air, primarily ammonia, considered as a significant risk factor for public health, which should be considered when planning and conducting preventive measures to minimize this risk, when determining the timing of settlement of new residential and publicpremises, as well as, the optimization of the resource provision of laboratory control over the air condition of residential premises. Key words: indoor air, enclosed spaces, ammonia, health risk assessment, volatile organic compounds.
MORBID OBESITY IN ADOLESCENTS (REVIEW)
E.B. Milner1, D.A. Shirokov2.3, I.A. Leonova4 1AVA-PETER company, Russia, 191186, Saint-Petersburg, Nevsky Prospect, 22-24A, room 50 2 ITMO University, Russia, 197101, Saint Petersburg, Kronverkskiy pr., 49, lit. A 3Peter the Great St. Petersburg Polytechnic University, Russia, 195251,Saint-Petersburg, Polytechnic, 29 4 Pavlov First Saint Petersburg State Medical University, Russia, 197022, Saint-Petersburg, Leo Tolstoy Street,6-8 Аbstract Introduction. According to the World Health Organization (WHO), almost 13% of world population suffer from the obesity. In addition, some estimates predict further increase of obese children and adolescents up to 9.1% of whole population (it is about 60 million children). Childhood obesity has short-term and long-term negative consequences for both physical and mental health. Such trends determine the importance and relevance of the further search of effective ways to combat childhood obesity. The aim of the study was to analyze the main reasons of increase of morbid obesity cases among adolescents, and to determine the promising directions of further prevention and treatment methods. Material and methods. The article presents a literature review on the morbid obesity in adolescents.The literature was found in the electronic data bases: PubMed, Cochrane Library, Medscape, and the Elibrary Scientific Electronic Library. The following key words were used: “children”, “morbid obesity” and “bariatric surgery”. In addition, all the articles were filtered out chronologically, so that articles published no earlier than 2012 were included in the final analysis. About 52 foreign and Russian publications were used for analysis. Results. In accordance with clinical recommendations, the use of bariatric surgery for adolescents in the Russian Federation is prohibited. However, there are a great number of publications on the effectiveness of bariatric surgery in the treatment of obesity in adolescents. Conclusion. Bariatric surgery combined with psychological counseling, could be an effective way to struggle with adolescent obesity. The selection criteria for adolescents for bariatric surgery requires discussion and the development of effective standards. Key words: morbid obesity, adolescents, bariatric surgery, overweight, BMI.
ASSESSMENT OF MANIFESTATIONS AND PREDICTION OF TUBERCULOSIS MORBIDITY IN THE TERRITORIES OF THE NORTH-WEST OF RUSSIA
V.V. Vetrov1, L.V. Lyalina1,2, S.L. Plavinskii2,O.A. Historik3 1Federal State Budgetary Institution «St. Petersburg Research Institute of Epidemiology and Microbiology named after Pasteur» Rospotrebnadzor,Russia, 197101, St. Petersburg, ul. Mira, d. 14 2FGBOUVO «N-West State Medical University named after I.I. Mechnikov» of the Ministry of Health of torthhe Russian Federation, Russia, 191015, St. Petersburg, ul. Kirochnaya, d. 41 3Office of Rospotrebnadzor in the Leningrad Region, Russia, 192029, St. Petersburg, ul. Olminsky, d. 27 Abstract. Introduction. Tuberculosis is one of the socially significant problems in the world and in Russia. The World Health Organization has developed a strategy of tuberculosis elimination for the period until 2035. In the Russian Federation, there is a tendency to reduce the incidence of tuberculosis and mortality from this infection. The aim of the study. Determination of epidemiological features of tuberculosis and prognosis of morbidity in the territories of the North-West of Russia. Materials and methods. Regional features of the incidence of tuberculosis in the territories of the North-West Federal District were studied for the period 2006-2018. Statistical data processing was performed using the WinPepi software product (version 11.65). To compare epidemiological indicators, a 95% confidence interval was used.. To predict the incidence rate, the ARIMA model was used taking into account existing trends. Results. In the last decade, there has been a tendency to reduce the incidence of tuberculosis in all territories of the North-West of Russia. In 2018, there was a statistically significant decrease in the incidence rate compared to 2015. In one area of the district, the incidence of combined infection caused by M. tuberculosis and HIV was higher than in other areas. In the three territories in 2010-2018, there was a tendency to increase the proportion of patients with a first-time diagnosis of tuberculosis caused by M. tuberculosis with multiple drug resistance.
The results of forecasting the incidence of tuberculosis in the territories of the North-West of Russia showed that in 2025 in two territories the incidence rate will be less than 5 per 100,000 population, in three territories - up to 10 per 100,000, in 5 territories - from 15 to 20 per 100,000, in one territory - up to 30 per 100,000. Conclusion. According to the results of the study, the possibility of achieving the target tuberculosis incidence rate recommended by the World Health Organization on the territory of the North-West Federal District of the Russian Federation in 2035 was established. Key words: Incidence of tuberculosis, multidrug resistance, prediction of morbidity.
S.L. Plavinskii1, P.I. Shabalkin2 1North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya Street, 41 2Clinic of Dr. Fomin, Russia, 127006, Moscow, Dolgorukovskaya street 17, building 1
Abstract Introduction. Melanoma skin cancer is one of the leading oncological diseases in Russia. Drug therapy is a main form of treatment of disseminated disease forms including chemotherapy, targeted therapy and immune therapy. The aim of the study was toper form pharmaco economic analysis of the decision to include recombinant human interferon gamma into combination therapy for melanoma. Materials and Methods. It was formulated a Markov model comprising three health states: disease without progression, disease progression and death. Transition probabilities from one state to another, usefulness for the health states were taken from the literature. Results. Data modeling demonstrated high clinical and economical effectiveness of using interferon gamma in combination chemotherapy of melanoma skin cancer. Quality-adjusted life year was 0.402 by including interferon gamma to the chemotherapy, and accompanied by additional 7,2 month of life and 4,8 months of life without disease progression, whereas one day of life costs of 52528 rubles. Budget impact analysis revealed insignificant increase of budget whileincludinginterferon gamma to combination chemotherapy of melanoma. Conclusion. The use of recombinant human interferon gamma in the combination chemotherapy of skin melanoma resulted in prolongation of the quality life and reduce the rate of moving to progression state with relatively small increase in budget expenses. Keywords: melanoma skin cancer, recombinant Human Interferon, Quality-Adjusted Life Years (QALY), budget impact analysis.
PHARMACOECONOMIC ANALYSIS OF THE INITIAL TREATMENT OF RHEUMATOID ARTHRITIS WITH TUMOUR NECROSIS FACTOR INHIBITORS
O.D. Gritsenko, P.A. Shesternya Krasnoyarsk State Medical University named after Prof. V.F. VoinoYasenetskyy, Russia, 660022, Krasnoyarsk, Partisan Zheleznyak St., Abstract Introduction. Inhibitors of tumor necrosis factor alpha are the most widespread group of disease-modifying antirheumatic drugs used in the treatment of rheumatoid arthritis. Currently, there are registered five drugs in this group. Given the high cost of these drugs, the conduction of a pharmacoeconomical analysis to identify the most optimal drug for initial therapy is of a high importance. Materials and methods. A retrospective analysis of the first six months of rheumatoid arthritis therapy with inhibitors of tumor necrosis factor alpha during 2013-2017 was carried out. Integral calculators of rheumatoid arthritis activity were used to determine the therapy effectiveness. The therapy safety and pharmacoeconomic analysis was carried out. Results. According to Boolean criteria and three scales, the cost-effectiveness was the smallest for adalimumab. During the comparative analysis of the performance indices, it was found that the percentage of remission for Disease Activity Score was statistically significantly higher than for other indices. Conclusion. The analysis revealed the optimal drugs, considering the results of pharmacoeconomic analysis, and shown the importance of use of several performance indices to assess the disease activity. Key words: rheumatoid arthritis, inhibitors of tumor necrosis factor alph, pharmacoeconomical analysis.
PREDICTORS OF HOSPITAL-ACQUIRED COMPLICATIONS IN PATIENTS WITH NON- FATAL MYOCARDIAL INFARCTION AND TYPE 2 DIABETES
O.K. Lebedeva, G.A. Kukharchik North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 Abstract Introduction. About a quarter of patients with myocardial infarction have type 2 diabetes mellitus, which significantly worsens the prognosis in this group of patients. Aim of study was to assess the significance of predictors of adverse outcomes of myocardial infarction in patients with type 2 diabetes mellitus due to development of hospital-acquired complications. Material and methods. The study included 107 diabetes patients with myocardial infarction including 61 patients (57.1%) with complicated non-fatal myocardial infarction, and 46 patients (42.9%) without complications. In addition to the clinical protocol for health examination and treatment, the modified Charlson comorbidity index, glycated hemoglobin level and high sensitivity C-reactive protein were evaluated for all patients discharged from the hospital. Results. Type 2 diabetes mellitus patients with non-fatal myocardial infarction had significantly higher levels of modified Charlson comorbidity index, left ventricular dilatation and right atrial volume index as well as hyperglycemia and higher C-reactive protein levels, and the decrease in the left ventricular ejection fraction. Conclusions. In patients with type 2 diabetes mellitus, a higher incidence of non-fatal hospital-acquired complications of myocardial infarction is observed, the predictors of which are comorbidity, an active systemic inflammatory reaction, reduced contractility of the left ventricular myocardium, dilatation of the left ventricle and right atrium, and hyperglycemia at admission. Keywords: myocardial infarction, type 2 diabetes mellitus, risk factors for myocardial infarction, complications of myocardial infarction
LONG-TERM EFFECT OF LEFT ATRIUM APPENDAGE RESECTIONON ON THE COURSE OF ARTERIAL HYPERTENSION IN PATIENTS AFTER OPEN -HEART SURGERY
А.V. Sotnikov, M.V. Mel’nikov, S.A. Boldueva, A.M. Bitieva, A.V. Karpov North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya Street, 41 Abstract Introduction. The effect of left atrial appendage resection on the further course of arterial hypertension in patients undergoing the cardiac surgeryas not been previously studied. The aim of the study was to analyze the longterm effect of left atrial appendage resection on the course of arterial hypertension (grade III). Material and methods. The study group consisted of 19 patients who had undergone the left atrial appendage resectionduringopen-heart surgery with severe arterial hypertension and atrial fibrillation, coronary artery bypass grafting and/or valve repair. In the referent group (22 patients with severe arterial hypertension), the open-heart surgery was performed without appendage resection. Results. In the study group, at the average of 3.8 years after operation, theincidence of hypertensive crisis significantly decreased, as well as, the frequency of visiting a doctor for arterial hypertension. The average number of antihypertensive medications taken by the patient remained constant (2.8 ± 0.3 at discharge vs 2, 9 ± 0.6 in the long term). In the referent group, the course of arterial hypertension was progressive. Conclusion. Left atrial appendageresectionhas a proven positive outcome on the further course of severe arterial hypertension. Key words: atrial fibrillation, arterial hypertension, systemic embolismprevention, open-heart surgery.
DYNAMICS OF HEART FAILURE AND LEFT VENTRICLE FUNCTIONS MANIFESTATIONS IN PATIENTS WITH MYOCARDIAL INFARCTION AFTER STENTING OF INFARCT-RELATED CORONARY ARTERY IN COMBINATION WITH MANUAL THROMBOASPIRATION
D.S. Maznev, I.A. Leonova, S.A. Boldueva North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya Street, 41 Abstract Introduction. Manual thromboaspiration is aimed at achieving optimal myocardial perfusion in patients with ST-segment elevation myocardial infarction treated by percutaneous coronary interventions. The aim of the study was toanalyze the dynamics of manifestations of chronic heart failure, features of left ventricular remodeling according to echocardiography in patients with ST-segment elevation myocardial infarction, treated by percutaneous coronary intervention in combination with manual thromboaspiration. Materials and methods. t was performed a two-year dynamic monitoring of two groups of patients with ST-segment elevation myocardial infarction: 174 patients who underwent percutaneous coronary intervention with manual thromboaspiration, and 176 patients with percutaneous coronary intervention without manual thromboaspiration. Results. During a two-year monitoring, a significant decrease in the severity of chronic heart failure, as well as the left ventricular myocardium remodeling in patients after myocardial infarction, who underwent percutaneous coronary interventions with manual thromboaspiration, was noted compared with patients without manual thromboaspiration. Conclusion: Manual thromboaspiration in addition to angioplasty and stenting of the infarct-related coronary artery resulted in the improvement of the course of chronic heart failure and a more favorable variant of left ventricular remodeling in patients with myocardial infarction with ST-segment elevation myocardial infarction. Key words: myocardial infarction with ST segment elevation, manual thromboaspiration, chronic heart failure, left ventricular remodeling
CLINICAL FEATURES OF ARTERIAL HYPERTENSION IN MALE PATIENTS ASSOCIATED WITH THEIR PSYCHOSOMATIC STATUS
N.P. Velichko1, A.Ya. Velichko2, G.А. Usenko3, D.V. Vasendin4, A.G. Usenko5, N.А. Schakirova6, V.G. Zabara7 1Novosibirsk city polyclinic №18. Russia, 630136, Novosibirsk, Schirokaya Str., 113 2Novosibirsk city clinical hospital №11. Russia, 630120, Novosibirsk, Tankistov Str., 23, 3Novosibirsk state medical University Ministry of healthcare of the Russian Federation. Russia, 630091, Novosibirsk, Krasny Av., 52 4Siberian State University of Geosystems and Technologies the Ministry of science and higher education of the Russian Federation. Russia, 630108, Novosibirsk, Plakhotnogo str., 10 5Novosibirsk regional hospital №2 for war veterans. Russia, 630005, Novosibirsk, Families of Shamshinykh Str., 95a 6Western-Siberian administration for Hydrometeorology and environmental monitoring. Russia, 630099, Novosibirsk, Sovietskaya Str., 30 7Military hospital №425 Ministry of defense of Russia. Russia, 630017, Military Str., 1
Abstract Introduction: Arterial hypertension is one of the main independent risk factors for complications of cardiovascular disease patients. In the structure of cardiovascular diseases, the hypertension is considered in recent years to be a leading cause of disability and mortality of the working population associated with increased psycho-emotional stress, anxiety and depression. Insufficient attention was paid to factors affecting the disease outcome and the assessment of the cardiometabolic risk. The aim of the study was to analyze the correlation between the autonomic nervous system activity, blood cortisol and aldosterone levels, as well as blood clotting time and the grade of complications in the groups of male patients with hypertension having depressive and anxious temperament scores Materials and Methods: Able-bodied male patients working in industrial sector aged from 44 to62 were examined at outpatient facilities, who suffer from hypertension stage III, grade 3, risk 4. The referent group was recruited from healthy men 485 ± 6 (per year), with the anthroposocial characteristics similar to those in study patients. The patients were divided into 8 temperament groups: 4 groups with high-anxiety and 4 groups with low-anxiety patients, in each group were 52 ± 4 patients. It was determined the prevailing type of temperament and depression. The activity of sympathetic and parasympathetic components of the autonomic nervous system was determined according to the Kerdo vegetative index. Serum cortisol and aldosterone levels in the blood were determined by radioimmune method. The state of blood coagulation was evaluated by clotting profile blood test and bleeding time, and by the volume of activated partial thromboplastin time. Fibrinogen concentration in the serum, prothrombin index, platelet concentrations in blood were also defined. Results: The group of male patients of mature age suffering from arterial hypertension (grade III), according to their psychological characteristics, is heterogeneous and is divided into persons with high and low anxiety levels, mild depression and the prevalence of a particular type of temperament associated with the autonomic nervous system: choleric and sanguine characterized by the prevalence of activity of the hypothalamic-pituitary-adrenal (cortisol) axis
over the renin-angiotensin-aldosterone system (aldosterone) and sympathicotonia (for highly anxious individuals hypersympathicotony combined with anxiety), and for phlegmatic and melancholic –blood clotting time and the number of patients with complications of hypertension increases directly proportional to the increase of aldosterone concentration in the blood: melancholy > phlegmatic > sanguine > choleric. Conclusion: The correlation between hemostatic parameters and levels of aldosterone and cortisol in blood of patients with hypertension was established. It is advisable to prescribe antihypertensive therapy aimed at blocking the psychosomatic characteristics of patients, depending on the temperament and level of anxiety. Key words: arterial hypertension, anxiety, depression, complications, blood clotting, hormones.
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