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Essential hypertension stage II was treated by calcium antagonists, alpha- and beta-adrenoblockers in 362 patients. The drugs were compared for hypotensive efficiency at rest and exercise. A significant hypotensive effect was achieved in 81%, 58%, 44%, 43% and 37% of patients treated with labetalol, nifedipine, nadolol, propranolol, diltiazem, respectively. An increase in verapamil daily dose from 240 to 600 mg led to a rise in efficacy from 27 to 75% without an increase in the number of side effects. The antihypertensive effect of the drugs is shown to persist in long-term treatment as shown by exercise tests and static loads.

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To evaluate the hypotensive efficacy and effects of some hypotensive drugs on the hemodynamics and concentration of testosterone in its blood plasma the authors examined 205 patients with juvenile hypertension (JH): main group--134 patients; comparison group--71 patients). Course treatment (1.5-2 months) with obsidan, niphedipin, verapamyl was carried out with nondrug treatment during intervals. The obtained data evidence efficacy of the hypotensive treatment. Most patients with JH showed a characteristic increase of the blood testosterone level. After a four-year treatment the testosterone level was within normal levels.

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A study of 100 patients with juvenile hypertension (JH) revealed a dependence between the character of changes of the cerebral vessel tone and type of central hemodynamics (TCH). Patients with the hypokinetic TCH show more frequently the vasospastic form of cerebral circulation (FCC) while the vasodilation FCC was observed rarer. The vasodilation FCC prevailed in patients with hyperkinetic TCH while the vasospastic was not observed. Normotensive FCC showed a similar frequency in patients with hypo- and hypertensive TCH. In patients with vasospastic FCC and hypokinetic TCH the drug of choice was nifedipin while in patients vasodilatation FCC and hyperkinetic TCH this was propranolol.

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The general and local ejection fractions (EF) of the left ventricle were studied in 112 patients with grade I hypertensive disease and in 20 practically healthy persons at rest and during static isometric loads. At rest general and local EF were diverse. During loads both reduction and increase of general EF were observed. Increase of general and local EF is a result of adequate physiological reaction of the myocardium while their reduction indicates limitation of the myocardial reserve of the left ventricle.

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The effect of anapriline, corinfar and reserpine on parameters of hemodynamics and plasma testosterone was evaluated in 60 juvenile hypertension patients who achieved pronounced hypotensive response. It was established that the level of sex hormones tended to diminution by the end of the treatment month 1 or 2, this drop being more noticeable in reserpine administration. Basing on this evidence it would be beneficial for patients suffering from juvenile hypertension in need of chemotherapy to take courses of the above drugs.

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The state of 48 patients with hypertensive disease was studied before and in the course of prolonged anaprilin monotherapy. Most patients with an initially increased mass of left ventricle myocardium (MLVM) showed beginning with the third month a reduction of this mass due to decrease in the thickness of the posterior wall and interventricular septum accompanied by an increased tolerance of the patients to physical load.

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The authors analyzed 255 case records of patients with symptomatic arterial hypertension treated in the Clinics of the Kiev Research Institute of Cardiology in 1985-1986 with the purpose of differential diagnosis of AH on the out-patient stage. It is concluded that the outpatient level of diagnosis was insufficient mainly due to the subjective character.

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Hemodynamic and humoral indices were studied in patients with juvenile hypertension before and after a months treatment course with obsidan. The beginning of the disease was in 18% distinguished by an increased thickness of the wall and interventricular septum. Obsidan treatment (0.5 mg/kg of body weight) resulted already during the first 2-4 weeks and then on the 3 and 6 month in an improvement of the general condition, normalization of the systolic pressure, cessation of tachycardia, reduction of the elevated cardiac index, reduction of the rate of circular shortening of the myocardial fibers, plasma renin activity and amount of blood aldosterone. Resistance to the effect of obsidan was noted in 10.5%. Some patients showed side-effects.

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Blood angiotensin-converting enzyme, renin, kallikrein and prekallikrein ratios were investigated in 61 essentially hypertensive patients at rest and during rationed exercise. Biochemical findings were compared with major parameters of systemic hemodynamics measured under the same conditions. Grouping of patients on the basis of renin activity was mirrored in different levels of the angiotensin-converting enzyme and kallikrein: increased renin activity was accompanied by the activation of the said enzymes, and reduced activity, by their suppression. Rationed exercise did not produce noticeable kallikrein-kinin shifts in hypertensive patients, their renin-angiotensin response depending on the baseline. The markedness of hemodynamic change in response to exercise differed in patients with different humoral background.

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