The use of thiazide, thiazide-like and loop diuretics in patients with hypertension is widely discussed. So far, there have been few direct comparative studies of different classes of diuretics in hypertension. The randomized, comparative, open DOVERIE study (efficacy and safety of Diuver in combination therapy in hypertensive patients in outpatient setting) found that the antihypertensive effects and safety of torasemide and indapamide are not significantly different. Adding torasemide either to monotherapy with ACEI/ARB II or as substitute for hydrochlorothiazide in combination therapy with ACEI/ARB II + HCTZ resulted in a further significant decrease in blood pressure and allowed to reach target BP in a majority of patients. Therapy with torasemide was not associated with any increase in heart rate, significant changes in potassium levels, uric acid and glucose.

Cardiovascular diseases remain the most common pathology worldwide, the pharmacotherapy of which remains relevant for the majority of patients over a long period of time, sometimes for life. The main purpose of pharmacotherapy of cardiovascular diseases is prevention of complications and mortality. Cardiovascular drugs must have high proven efficacy and safety in achieving the long-term prognosis.

Cardioembolic complications such as ischemic stroke and non-central nervous system venous thrombosis are among the most serious consequences of atrial fibrillation (AF) [1, 2]. The most effective way to prevent the complications is a long-term (indefinitely long) administration of anticoagulants, which, according to modern beliefs, are indicated in patients with atrial fibrillation with additional risk factors for cardiovascular complications.

Effective care in acute coronary syndrome (ACS) is aimed to reduce mortality from cardiovascular causes, reduce mortality and disability of patients of working age, as well as decrease the financial burden. The key aspect of treatment of ACS patients is effective antiplatelet therapy, especially in high-risk patients and patients undergoing percutaneous interventions. Clopidogrel today remains one of the most widely used drugs in the treatment of such patients. Application of generic forms of clopidogrel in clinical practice is quite common. At the same time, there are methodological difficulties in assessing the equivalence of the original and reproduced forms due to the specificity of the pharmacokinetic and pharmacodynamic properties of clopidogrel. The currently available data are not enough for a clear prognosis of administration of generic forms in patients with ACS.

Despite the widely used myocardial revascularization (angioplasty and stenting, aorto- or mammo-coronary bypass), extensive pharmacotherapy aimed at improving the quality of life (through the improvement of exercise tolerance and elimination of angina attacks) and increasing its "quantity", i.e. improving the prognosis, coronary heart disease remains the leading cause of overall mortality in the world and in Russia. In a majority of patients, angina persists even after revascularization of the myocardium, therefore they still need antianginal therapy. [1] Additionally, for some patients revascularization is not possible because of anatomical features of coronary vessels and contraindications to medicines traditionally used in angioplasty.

For many years, coronary heart disease (CHD) has been the main cause of death in many developed countries. At present, cardiovascular diseases (CVD) play a crucial role in the evolution of total mortality in Russia. CVD mortality in Russia in 2013 amounted to 857 cases per 100 thousand residents, of which nearly 50% were deaths from coronary heart disease. CVD treatment and relief of clinical manifestations are among the priority tasks in modern cardiology.

Mechanisms of action and clinical application of vasodilator molsidomine (direct nitric oxide donor) in patients with stable coronary heart disease are considered. Results of the clinical studies are discussed; the efficacy of use and place of molsidomine (Sydnopharm) in the treatment of patients with stable angina are evaluated.

The article is a literature review on the problem of thromboembolic complications in non-valvular atrial fibrillation, the peculiarities of anticoagulant therapy and challenges associated with the selection of drugs for stroke prevention.

In all urbanized countries, more than half of overall mortality is conditioned by diseases caused by atherothrombosis in the arteries of heart and brain. In Russia, as compared with Europe and the United States, the mortality rate is 3-5 times higher. The key factors that in many countries contributed to a reduction in mortality over the past 15-20 years, in addition to overall popularization of a healthy lifestyle and healthy diet, was the widespread use of antiplatelets for the prevention and treatment of atherothrombotic events in high-risk groups. However, in populations with low risks of coronary artery disease and brain ischemia, aspirin therapy did not result in a decrease in cardiovascular mortality, which was confirmed by a follow-up of 95,000 patients at low risk for an average period of 6.9 years. [1]

The review of literature discusses pathogenetic aspects of chronic heart failure and post-infarction remodelling in the heart. The focus is on the role of neurohormonal activation and the important role of aldosterone. There is data on the efficacy and safety of drugs belonging to mineralocorticoid receptor antagonists obtained in the course of randomized clinical trials. Different aspects of clinical application of the selective aldosterone receptor blocker eplerenone are emphasized. The application in clinical practice is supported by research findings.

The article presents the results of a 6-month long-term therapy with angiotensin II receptor blocker Valsacor and aldosterone receptor blocker Spironolactone in patients with chronic heart failure (CHF) against a background of ischemic and/or post-infarction left ventricular remodelling. The results show that the renin-angiotensin-aldosterone system (RAAS) blockade in the combination therapy slows down the pathological remodelling of the left ventricle (LV) and thus prevents progression of CHF in a majority of patients with myocardial infarction (MI).

Currently, ACE inhibitors are considered to be the gold standard in the treatment of cardiovascular diseases. They all have cardio-, vaso- and nephroprotective and positive metabolic effects; however, despite the large number of the so-called class effects, the drugs differ in pharmacokinetic characteristics which determine the difference in their clinical effects. The article is about choosing the optimal drug from the group of ACE inhibitors in clinical practice.

Pulmonary embolism (PE) is a rather common emergency situation. Occlusion of pulmonary arteries of different calibre may result in critical condition, shock, sudden death, while in a number of patients who survived thromboembolism it may lead to long-term complications of varying severity: post-thromboembolic chronic pulmonary hypertension, changes in respiratory biomechanics and respiratory failure, and so on. In most cases blood clots enter the pulmonary arterial tree (up to 90% of cases) from the venous system of the lower extremities, pelvis, kidney, and quite rarely from the right side of the heart and the venous system of the upper extremities [1].

The potential of certain drugs to affect specific markers of progression of hypertension should be taken into account in the rational pharmacotherapy of arterial hypertension (AH) in patients with metabolic syndrome (MS). Pharmacodynamic effects of the beta-blocker (BB) nebivolol, the average daily dose 5,3 ± 2,5 mg, were studied in 29 patients with stage I - II hypertension with signs of MS (men - 15, women - 14; mean age 52, 4 ± 10,32 years). Nebivolol, along with a high antihypertensive efficacy (achievement of target blood pressure in 76% of patients) and good safety profile, provides a complex effect on specific markers of inflammation and disorders of carbohydrate metabolism. The study showed a decrease in the high-sensitivity C-reactive protein (hs-CRP) from 3.15 (2.0; 4.18) mg/l to 2.3 (1.18; 4.03) mg/l (p = 0.001), intercellular adhesion molecules (iCAM-1) from 330,23 (295.7; 387.3) ng/ml to 310.07 (252.72; 370.4) ng/ml (p = 0.044) with no adverse effect on insulin resistance, as well as a reduction in the adipokine activity and overall cardiovascular risk.

Familial hypercholesterolemia (FHC) is the most common and most severe form of monogenic dyslipidemia with early and rapidly progressing atherosclerosis and its complications [1--4, 12, 14]. Without treatment, the prognosis for patients with FHC is as heavy as for AIDS patients. For the first time the molecular defect - absence or dysfunction of the LDL receptor (LDL-R), the main route for cholesterol catabolism in humans [2, 3, 12, 13] - was described with regard to this genetic disease. The article analyzes a clinical case of the disease in a 9-year-old boy.

The global increase in the prevalence of diabetes mellitus (DM) is a serious public health problem. DM is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both (WHO, 1999). Currently, there are 382 million people with diabetes worldwide; forecasts are disappointing: by 2035, the figure will exceed 592 million [8]. The vast majority are patients with type 2 diabetes (DM 2). According to the State Register, in Russia (2013), the number of diabetic patients was 3 million 770 thousand, of whom 3.5 million had DM 2 [1].

The priority task of the current public policy, incl. in the reformation of education, is to maintain and improve health. Health of the nation is an economic and political notion and a determinant of social stability. It also defines the labor potential of the country and its defense capacity. Only healthy people can produce material wealth, succeed in school and become good specialists. Without them is impossible or scientific and technical progress, no progress in the economy and other areas of management. According to the new Federal state educational standards, health is one of the components of professional training which characterizes competitiveness of a specialist.