Набережные Челны, 2010 г

1. ????????? ?????? ???????,???????????? ? ???????????? ???????? ????????

3. ???????????? ??????? ??? ???????????? ??????? ?? � ??????? ??????? ????????????? ?????????????????? ? ???????????? ???????????????????? ????????? ??????????? ????? ??????? ????????? ??????? ?????? � ?????????? ????? ?????? ??? ???????????? ???????? ???????? ? ????????? ????? ????? ???????? ? ????????????? (????????????) ???????????

4. ???? (????? ????????) ??? ?????????????, ??? ? ?????????? COX-2 ?? ????? ????????????? ??????? ?????? ???? ???????? ??-?? ?????????? ????? ?????? ?????????? ????????, ???????????, ????????? ??????????????? ? ??????? ????????

5. ???????, ?????????? ??? ?????? ???? ?????????????: ?? ?????? ?? ?????????????? ????????

8. ????????????? ?????????? ?????????????????? ???????

9. ????????????? ???????????? ????? ???????? ?? ???????????? ???????????? ????????

10. ??????????: ??????????? ???????????? ????????????? ?????????? ??????, ??????? ??? ??????? ????? ???

12. ????????: ??????????????? ??? � ???????? ?????????? ??? ???????? ??????? ???????? ??????????? ????????? ??? ???????? ??????? ???????????? ? ?????????????? ??????????? ????????? (Coagucheck S �)

15. ?????????? ? ????????? ??????? ????????

16. ???????????? ?? ??????? ???????? ???????? ? ???????? ???????? ST ?????????? ????? � ??????????? � ??????????????? ??????? ?????????? ??? ??????????? ???? ??????? ?? ????????????? ?????? ?????. ?????? ?????????? ????????????? ?????????? ??????? ???????? ????? (???????? ??, ????????? ??, ????? ?? ?? Killip = II [???? ???????, ????? ? ??????, ???????? ?????? ?? ????????], ???? < 40%)

17. ???? ? ????? ??????? ????? ??

18. ??????? ?????????? ? ???????? ???? ?? ?????? ????????. ???, ??????? ????????????? ??????? (????? ????? ???.), ? ?????? ????? ????? ????????????????? ? ??????????????? ????????. ????????, ??? ?????????? ?? ?? ???? ?????????????? ????????????? ??????? ??????? ?????????? ?????????? ???????? ?????, ? ???????? ???? ? ??????????????? ???????????? ??????????? ??????????? ?????? ????????????? ???????? ? ???????? ?????? ??????? ? ???????? ?????????. ???????? ?? ???? ???????? ??????????? ??????????????? ??????????? (?????? ????? ???.). ???, ? ???????? ???????? ??????????????? A-II ?????????? ????????????? ? ???????? ???????? ??????????? ???????? ??????? ? ?????????? ??????? ????????? III ????, ??????????? ??? ????????????? ???????? (??????????????? ??????). ????? ????, A-II ??????????? ????????? ?????? ?????????????, ????????? ????????? ???. ?????????? ??????????? ????????? ? ??????? ??????????? ?????????????? ??????? ? ?? ??????????? ????????????. ? ?????? ?????????? ????????? ????????? ???? ???????????? ???????? ??????????? ??????????? ? ??????????? ?????? ?????????. ??????? ? ????????????? ???????, ????? ?? ????????? ????, ?? ???????????? ?? ?????? ? ?? ??????? ?? ??????? ?????????????, ????????????? ? ?????? ??????????? ??????, ??????? ??????????? ??? ??????? ?????????? ????, ?? ?????? ????? ?? ?????????????????? ???????? ????, ????????????? ??? ?? ?????????? ?????????? ? ????????? ? ???????? ???? ?? ???????? ??????. ??????? ?????????? ? ???????? ???? ?? ?????? ????????. ???, ??????? ????????????? ??????? (????? ????? ???.), ? ?????? ????? ????? ????????????????? ? ??????????????? ????????. ????????, ??? ?????????? ?? ?? ???? ?????????????? ????????????? ??????? ??????? ?????????? ?????????? ???????? ?????, ? ???????? ???? ? ??????????????? ???????????? ??????????? ??????????? ?????? ????????????? ???????? ? ???????? ?????? ??????? ? ???????? ?????????. ???????? ?? ???? ???????? ??????????? ??????????????? ??????????? (?????? ????? ???.). ???, ? ???????? ???????? ??????????????? A-II ?????????? ????????????? ? ???????? ???????? ??????????? ???????? ??????? ? ?????????? ??????? ????????? III ????, ??????????? ??? ????????????? ???????? (??????????????? ??????). ????? ????, A-II ??????????? ????????? ?????? ?????????????, ????????? ????????? ???. ?????????? ??????????? ????????? ? ??????? ??????????? ?????????????? ??????? ? ?? ??????????? ????????????. ? ?????? ?????????? ????????? ????????? ???? ???????????? ???????? ??????????? ??????????? ? ??????????? ?????? ?????????. ??????? ? ????????????? ???????, ????? ?? ????????? ????, ?? ???????????? ?? ?????? ? ?? ??????? ?? ??????? ?????????????, ????????????? ? ?????? ??????????? ??????, ??????? ??????????? ??? ??????? ?????????? ????, ?? ?????? ????? ?? ?????????????????? ???????? ????, ????????????? ??? ?? ?????????? ?????????? ? ????????? ? ???????? ???? ?? ???????? ??????.

19. ??????? ???????? ? ??? ?????????? ??? � ????????? ?????????? ?????? ???* � ??? ?????? ????????????? ??????????? ??? ? ????????? ?? ????????? ?? (<40%) ???* � ??? ???????????? ??????????? ??? ? ????????? ?? ????????? ?? (<40%)

20. ????????: ?????????? ?????????????????? ??????, ??????? ??????? ???????? ????, ????????? 24-???????? ??????? ????????????? ??????????? ????? 24-??????? ?????? ?????????????, ????? ??????????????? ?? ???? ??? (1,2). ?????????? ?????? ????????????? ???????????? ??????????? ?????????????????? ????????????? ????????? ?? ????, 24?.-???????? ???????????, ??????? ?????? ???????? ????. Burnier M, Brunner HR. Angiotensin II receptor antagonists. Lancet 2000;355:637�645. Brunner HR. The new oral angiotensin II antagonist olmesartan medoxomil: a concise overview. J Hum Hypertens 2002;16 (Suppl 2):S13�S16.??????????? ????? 24-??????? ?????? ?????????????, ????? ??????????????? ?? ???? ??? (1,2). ?????????? ?????? ????????????? ???????????? ??????????? ?????????????????? ????????????? ????????? ?? ????, 24?.-???????? ???????????, ??????? ?????? ???????? ????. Burnier M, Brunner HR. Angiotensin II receptor antagonists. Lancet 2000;355:637�645. Brunner HR. The new oral angiotensin II antagonist olmesartan medoxomil: a concise overview. J Hum Hypertens 2002;16 (Suppl 2):S13�S16.

21. ???????????: ????? ?????? ???????? ????????? ? ?????? ??? Unlike other ARBs, only 1% of a telmisartan dose in excreted by the kidney.1 Up to 50% of the dose of other ARBs is excreted by the kidney.1 Renal impairment is unlikely to affect the pharmacokinetics of telmisartan. Song JC, White CM. Olmesartan medoxomil (CS-866). An angiotensin II receptor blocker for treatment of hypertension. Formulary 2001;36:487�499.Unlike other ARBs, only 1% of a telmisartan dose in excreted by the kidney.1 Up to 50% of the dose of other ARBs is excreted by the kidney.1 Renal impairment is unlikely to affect the pharmacokinetics of telmisartan. Song JC, White CM. Olmesartan medoxomil (CS-866). An angiotensin II receptor blocker for treatment of hypertension. Formulary 2001;36:487�499.

22. ???????????? ?? ??????? ???????? ???????? ? ???????? ???????? ST ?????????? ????? � ??????????? � ??????????????? ??????? ??????????? ???????????? ???????? ??????? ? ??????????? ???????? ???????? ??????????????? ??? ?????????????, ??? ?????????? ??????????????? ???? ????, ? ?? ? 40%, ? ????? ???????? ??? ????????? ????????????????.

23. ??????????? ?? ??????? ????? ????????? ? ????????? ???????????? ???????? ????????

24. ????????? ???????????? ???????? ???????? ? ???????? ???????? ST

25. ????????? ???????????? ???????? ???????? ? ???????? ???????? ST ???????? ???? ????: ?????? ????? ???? 18,5 � 24,9 ??/?� ?????????? ?????: ??? ?????? - < 35 - 87,5 ?? ??? ?????? - < 40 - 100 ?? ??????????? ??? ? ?????????? ?????. ??????? ???????? ???? ??????????? ?? ???? ???????. ?????? ??????????????? ??????????? ?? ???????? ????? ???? ? ?????????? ?????????? ??????????. ???? ?????????? ????? ????????? ??????? ??????????, ?????? ??????????? ?? ????????? ?????? ????? ? ??????? ??????????????? ????????.

26. ?????????? ??????????

27. ????????? ???????????? ???????? ???????? ? ???????? ???????? ST ?????????? ?????????? ???????: 30 ????? 2-4 ???? ? ?????? ??????????: ????????? ??????? ???? ? ??????? ???????????? ?????, ????????????? ???. 30-60 ????? ???????? ????? ?????????, ?? ?? ??????? ???? 3-4 ???? ? ?????? (??????, ??? ???????, ?????????, ?????? ?????????? ?? ?????? ???????), ??????????? ??????????? ?????????? ??????? ???????? (?????? ?????? ?? ??????, ?????? ?? ???? ? ????). ????????? ???????????? ????????????? ??????? ????? ???, ???????? ??? ??????? ?????? ?????????????? ???????? ????? ?/??? ??????? ? ????????? ? ??????? ??????, ??????? ???????? ????????????? ????????.

28. ??????? ??????�

29. ????? ?? ???????: ?????????????? ????????????? Smoke-free Legislation and Hospitalizations for�Acute�Coronary�Syndrome Jill P. Pell, M.D., Sally Haw, B.Sc., Stuart Cobbe, M.D.,� ABSTRACT Background�Previous studies have suggested a reduction in the�total number of hospital admissions for�acutecoronary�syndrome�after the enactment of legislation banning smoking in public�places. However, it is unknown whether the reduction in admissions�involved nonsmokers, smokers, or both. Methods�Since the end of March 2006, smoking has been prohibited�by law in all enclosed public places throughout Scotland. We�collected information prospectively on smoking status and exposure�to secondhand smoke based on questionnaires and biochemical�findings from all patients admitted with�acute�coronarysyndrome�to nine Scottish hospitals during the 10-month period preceding�the passage of the legislation and during the same period the�next year. These hospitals accounted for 64% of admissions for�acute�coronarysyndrome�in Scotland, which has a population�of 5.1 million. Results�Overall, the number of admissions for�acute�coronary�syndrome�decreased from 3235 to 2684 � a 17% reduction�(95% confidence interval, 16 to 18) � as compared with�a 4% reduction in England (which has no such legislation) during�the same period and a mean annual decrease of 3% (maximum decrease,�9%) in Scotland during the decade preceding the study. The reduction�in the number of admissions was not due to an increase in the�number of deaths of patients with�acute�coronary�syndrome�who�were not admitted to the hospital; this latter number decreased�by 6%. There was a 14% reduction in the number of admissions�for�acute�coronarysyndrome�among smokers, a 19% reduction among�former smokers, and a 21% reduction among persons who had never�smoked. Persons who had never smoked reported a decrease in�the weekly duration of exposure to secondhand smoke (P<0.001�by the chi-square test for trend) that was confirmed by a decrease�in their geometric mean concentration of serum cotinine from�0.68 to 0.56 ng per milliliter (P<0.001 by the t-test). Conclusions�The number of admissions for�acute�coronary�syndrome�decreased after the implementation of smoke-free legislation.�A total of 67% of the decrease involved nonsmokers. However,�fewer admissions among smokers also contributed to the overall�reduction. Source Information Smoke-free Legislation and Hospitalizations for�Acute�Coronary�Syndrome Jill P. Pell, M.D., Sally Haw, B.Sc., Stuart Cobbe, M.D.,� ABSTRACT Background�Previous studies have suggested a reduction in the�total number of hospital admissions for�acutecoronary�syndrome�after the enactment of legislation banning smoking in public�places. However, it is unknown whether the reduction in admissions�involved nonsmokers, smokers, or both. Methods�Since the end of March 2006, smoking has been prohibited�by law in all enclosed public places throughout Scotland. We�collected information prospectively on smoking status and exposure�to secondhand smoke based on questionnaires and biochemical�findings from all patients admitted with�acute�coronarysyndrome�to nine Scottish hospitals during the 10-month period preceding�the passage of the legislation and during the same period the�next year. These hospitals accounted for 64% of admissions for�acute�coronarysyndrome�in Scotland, which has a population�of 5.1 million. Results�Overall, the number of admissions for�acute�coronary�syndrome�decreased from 3235 to 2684 � a 17% reduction�(95% confidence interval, 16 to 18) � as compared with�a 4% reduction in England (which has no such legislation) during�the same period and a mean annual decrease of 3% (maximum decrease,�9%) in Scotland during the decade preceding the study. The reduction�in the number of admissions was not due to an increase in the�number of deaths of patients with�acute�coronary�syndrome�who�were not admitted to the hospital; this latter number decreased�by 6%. There was a 14% reduction in the number of admissions�for�acute�coronarysyndrome�among smokers, a 19% reduction among�former smokers, and a 21% reduction among persons who had never�smoked. Persons who had never smoked reported a decrease in�the weekly duration of exposure to secondhand smoke (P<0.001�by the chi-square test for trend) that was confirmed by a decrease�in their geometric mean concentration of serum cotinine from�0.68 to 0.56 ng per milliliter (P<0.001 by the t-test). Conclusions�The number of admissions for�acute�coronary�syndrome�decreased after the implementation of smoke-free legislation.�A total of 67% of the decrease involved nonsmokers. However,�fewer admissions among smokers also contributed to the overall�reduction.

30. ????????? ???????????? ???????? ???????? ? ???????? ???????? ST ?????? ??????????? ??????? ?????????? ?????????? ?????????????? ??????, ?????????? ????????????? ???????? ? ?????? ????? ?????????? ??????? ??? ?????????????? ?????????? ???????. ?????????? ????????????, ????????????????? ??????? (?????????? ????????), ????????? ?? ??????????? ??????? ??? ?????????????.

31. ???????? ????????????? ???????? ????: <140/90 ?? ??.??.; <130/80 ?? ??.??. ??? ??????? ? ??????????? ???????????? ????? ??? ????????

32. ???????? ????????????? ???????? ???? ?? 120/80 ?? ??.??. ? ????: ????????? ?????? ????? ??? ???? ??????? - ?????????? ??????????? ????????, ????, - ?????????? ??????????? ???????, ?????? ? ????????? ? ?????? ??????????? ?????

33. ???????? ????????????? ???????? ???? ?? 140/90 ?? ??.??. ? ???? ??? 130/80 ?? ??.??. ? ???? ??? ??????? ? ??????????? ???????????? ????? ??? ???????? : ???????? ????????????? ?????????, ??????????????? ????????????? ????-?????????? ??? ??????????? ?????-???????????-??????????????? ???????.

34. ????????? ??????????????? ?????????? (???) ??? ??????? ?? ??????????????? ???: ???????? ??????? ????????????? ??????????? / ????????????????? ????????? ??????? ????? ??????????? ?????? ????????? ????? ?? ???? ?????? ??????????? ??? ???????????? ?? ????????? ??????????????? ???????????? ??????? ?????????????? ???????? ?? ?????? ?????? ???????????? ?????????, ??????? ???????? ??????????? ????????????? ???????? ??????????? ? ?????????? ???.1 ?????? ?. ?. ??????????? ???????????? ?? ???????????? ?????????? 2007: ????????? ??????????????? ?????????? ????????? ???????// ??????? ??????????? ??????. 2007; ?.15 ?20: 1434 ?? ?????? ?????? ???????????? ?????????, ??????? ???????? ??????????? ????????????? ???????? ??????????? ? ?????????? ???.1 ?????? ?. ?. ??????????? ???????????? ?? ???????????? ?????????? 2007: ????????? ??????????????? ?????????? ????????? ???????// ??????? ??????????? ??????. 2007; ?.15 ?20: 1434

35. ?????????? ????????? ????????: ????????? ?????????? ??????? ?? ??????????? ??????????? ???????????? ????????-?????????? ?????????? ????? ??????? ????????? - ???????? ?????????????? ??????????? ????? ? ??????????? ????????? ?? ? ??????? ????? ? ??????????? ?????????????? ????????

36. ???????? ??????????? ?????????? ??????? ?? ? ????????? ? ????????? ???????? ??????? ?? ? 12-????????? ?????????????? ????????????????? ???????-?????????????? ???????????? ? ???????????? ??????? ?????????? ????????????? ???????????? ? ????? 40 ? 80 ?? ? ?????????? ? ???? 20 ?? ? 440 ??????? ? ?????? ? ????????? ???????????? ???????????.1 ? ?????? ???????????? ???????? ????? ?????????? ???????? ????????????? ????????, ??? ? ?????? ??????????, ????????????? ???????? ???????? ???????? ??? ??????, ?????????? ??????????? 80 ??. ???????????? ???????? ????????????? ???????? ???? ?????????? ? 4 ?????? ? ??????????? ?? 12 ??????. Smith DHG, et al. Once-daily telmisartan compared with enalapril in the treatment of hypertension. Adv Ther 1998;15:229�240. 8-?????????, ?????????????, ?????????????????, ???????? ???????????? ????????? ? ??????? ? ??????? ???????????? ???> 115 ??.??.??, ? ??????? ???????????? ???????? ?????????? ??????????? 80-160 ?? + ???? 25 ?? + ????????? 5 ?? ? ????????? 20-40 ?? + ???? 25 ?? + ????????? 5 ?? ?? ??????? ????????? ??????? (2). 2. Neutel JM et al, IJCP, 1999, Vol 53 N3? 12-????????? ?????????????? ????????????????? ???????-?????????????? ???????????? ? ???????????? ??????? ?????????? ????????????? ???????????? ? ????? 40 ? 80 ?? ? ?????????? ? ???? 20 ?? ? 440 ??????? ? ?????? ? ????????? ???????????? ???????????.1 ? ?????? ???????????? ???????? ????? ?????????? ???????? ????????????? ????????, ??? ? ?????? ??????????, ????????????? ???????? ???????? ???????? ??? ??????, ?????????? ??????????? 80 ??. ???????????? ???????? ????????????? ???????? ???? ?????????? ? 4 ?????? ? ??????????? ?? 12 ??????. Smith DHG, et al. Once-daily telmisartan compared with enalapril in the treatment of hypertension. Adv Ther 1998;15:229�240. 8-?????????, ?????????????, ?????????????????, ???????? ???????????? ????????? ? ??????? ? ??????? ???????????? ???> 115 ??.??.??, ? ??????? ???????????? ???????? ?????????? ??????????? 80-160 ?? + ???? 25 ?? + ????????? 5 ?? ? ????????? 20-40 ?? + ???? 25 ?? + ????????? 5 ?? ?? ??????? ????????? ??????? (2). 2. Neutel JM et al, IJCP, 1999, Vol 53 N3

37. ??????????? ??? ??? : ?????? ???????, ?????? ???????? ?? ?? ?????? ???????????? ?????????? ????????? ???????????? ? ???????? 75 ??????? ? ????????? ??? ??????? ???????????? ??????????? (??? 160�190 ?? ??.??., ??? 90�110 ?? ??.??.), ??????? ?? ????? ?? ???????? ???????. ???????? ???????? ??????????? ? ???? 40 ?? ???? ??? ? ???? ? ???????????? ??????????? ?? 80 ?? ????? 1 ?????? (n=25), ???????? ? ???? 2,5 ?? ???? ??? ? ???? ? ???????????? ??????????? ?? 5 ?? ????? 1 ?????? (n=25) ??? ??????????? 40 ?? ???? ??? ? ???? ???? ???????? 2,5 ?? (n=25). ????????? ????????????????? ??????? ????????? 6 ???????. ? ?????? ???????????? ?????????? ??, ?????? ????? ???????? ?????? ????????? (?????), ??????? ??????-????? ?????? ??????? ? ??????? ??????????? ??????? ??????-????? ?????? ???????. ????????? ??????????? ???????? ????? 1, 3 ? 6 ??????? ????? ?????? ???????. ????? 6 ??????? ?? ???? ???? ???????? ??????? ?? ???? ?????????? ??????? ?? ????????? ? ???????? ???????, ??? ????????????? ??????????? ???????? ????? ????????. ????? 6 ??????? ??????? ????? ? ??????? ????????????, ????????? ? ?????????? ????????????+????????? ???????? ?????????????? ?? 11,4%, 9,9% ? 15,6%. ??????? ??????-????? ?????? ??????? ??????????? ?????????????? ?? 14,6%, 12,0% ? 18,2% (P<0,001 ??? ??????????????? ??????? ?? ????????? ? ????????????), ? ??????? ??????????? ??????? ??????-????? ?????? ??????? � ?? 7,8%, 4,3% ? 11,5% (P<0,01 ??? ??????????????? ??????? ?? ????????? ? ????????????). Petrovic J, Petrovic D, Vukovic N, Zivanovic B, Dragicevic J, Vasiljevic Z et al. Ventricular and vascular remodelling � effects of the angiotensin II receptor blocker telmisartan and/or the angiotensin-converting enzyme inhibitor ramipril in hypertensive patients. J Int Med Res 2005; 33(Suppl 1):39A-49A.?? ?????? ???????????? ?????????? ????????? ???????????? ? ???????? 75 ??????? ? ????????? ??? ??????? ???????????? ??????????? (??? 160�190 ?? ??.??., ??? 90�110 ?? ??.??.), ??????? ?? ????? ?? ???????? ???????. ???????? ???????? ??????????? ? ???? 40 ?? ???? ??? ? ???? ? ???????????? ??????????? ?? 80 ?? ????? 1 ?????? (n=25), ???????? ? ???? 2,5 ?? ???? ??? ? ???? ? ???????????? ??????????? ?? 5 ?? ????? 1 ?????? (n=25) ??? ??????????? 40 ?? ???? ??? ? ???? ???? ???????? 2,5 ?? (n=25). ????????? ????????????????? ??????? ????????? 6 ???????. ? ?????? ???????????? ?????????? ??, ?????? ????? ???????? ?????? ????????? (?????), ??????? ??????-????? ?????? ??????? ? ??????? ??????????? ??????? ??????-????? ?????? ???????. ????????? ??????????? ???????? ????? 1, 3 ? 6 ??????? ????? ?????? ???????. ????? 6 ??????? ?? ???? ???? ???????? ??????? ?? ???? ?????????? ??????? ?? ????????? ? ???????? ???????, ??? ????????????? ??????????? ???????? ????? ????????. ????? 6 ??????? ??????? ????? ? ??????? ????????????, ????????? ? ?????????? ????????????+????????? ???????? ?????????????? ?? 11,4%, 9,9% ? 15,6%. ??????? ??????-????? ?????? ??????? ??????????? ?????????????? ?? 14,6%, 12,0% ? 18,2% (P<0,001 ??? ??????????????? ??????? ?? ????????? ? ????????????), ? ??????? ??????????? ??????? ??????-????? ?????? ??????? � ?? 7,8%, 4,3% ? 11,5% (P<0,01 ??? ??????????????? ??????? ?? ????????? ? ????????????). Petrovic J, Petrovic D, Vukovic N, Zivanovic B, Dragicevic J, Vasiljevic Z et al. Ventricular and vascular remodelling � effects of the angiotensin II receptor blocker telmisartan and/or the angiotensin-converting enzyme inhibitor ramipril in hypertensive patients. J Int Med Res 2005; 33(Suppl 1):39A-49A.

38. ??????????? ?????????????????? ???????????? ?????? ? ???? ???????????? 24 ???????? ? ???????????? ??????????? ? ??????? 3 ??????? ???????? ??????????? 40 ??/???.1 ?? ???? ??????? ???????? ????????? ????? �?????-???????� (??-???) ?????????? ?????????. ??????? ???????????? ???????? ????? ?????????. ??????, ???????? ??-??? ???? ????? ??????????, ??? ????? ???? ?????????????? ?? ????????? ???????? ????????????? ????????. Uchida H, et al. Practical efficacy of telmisartan for decreasing morning home blood pressure and pulse wave velocity in patients with mild-to-moderate hypertension. Hypertens Res 2004;27:545�550. ? ???? ???????????? 24 ???????? ? ???????????? ??????????? ? ??????? 3 ??????? ???????? ??????????? 40 ??/???.1 ?? ???? ??????? ???????? ????????? ????? �?????-???????� (??-???) ?????????? ?????????. ??????? ???????????? ???????? ????? ?????????. ??????, ???????? ??-??? ???? ????? ??????????, ??? ????? ???? ?????????????? ?? ????????? ???????? ????????????? ????????. Uchida H, et al. Practical efficacy of telmisartan for decreasing morning home blood pressure and pulse wave velocity in patients with mild-to-moderate hypertension. Hypertens Res 2004;27:545�550.

39. ????????: ???????????? ????????? PPARy -?????????? ? ??????????????? ????????????? ????? ???? ??? ???????? PPAR-? ??????????? ???????????????? ? ????????, ????????? ??????? ????????????? ? ??????? ???? ?????????????. ? ???????????? ??????? ??????????? ????????? ??? ???????????? PPAR-g ? ????????? ??????? ???????????.1 ? ???? ??????? ??????????? ?????????????? ? ??????????? ???????? ???????????. ? ?????????????? ???????????? ?????? ??? ??????????? ? ???????????? 10 ?????/?. ??????????? ??? ???????????? ??????????, ?????????? ?????????? (? 27 ???) ?????????, ?????????? ??????? ????????? (? 2�3 ????) ?????????. ??? ?????????, ?????? ???????? PPAR-g ? ???? ??????? ???????? 140-??????? ????????? PPAR-g.1 ??????????? ????? ??? ???????????? ???, ??????? ??????? ????????? PPAR-g ? ????? ?????? ?????????????, ??????? ????? ??????? ? ??????????????? ???????? (1�5 ?????/?).1 ????? ???????, ??????????? ????????? ??? ????????? ??????? PPAR-g. Benson SC, Pershadsingh HA, Ho CI et al. Identification of telmisartan as a unique angiotensin II receptor antagonist with selective PPARg-modulating activity. Hypertension 2004;43:993�1002.???????? PPAR-? ??????????? ???????????????? ? ????????, ????????? ??????? ????????????? ? ??????? ???? ?????????????. ? ???????????? ??????? ??????????? ????????? ??? ???????????? PPAR-g ? ????????? ??????? ???????????.1 ? ???? ??????? ??????????? ?????????????? ? ??????????? ???????? ???????????. ? ?????????????? ???????????? ?????? ??? ??????????? ? ???????????? 10 ?????/?. ??????????? ??? ???????????? ??????????, ?????????? ?????????? (? 27 ???) ?????????, ?????????? ??????? ????????? (? 2�3 ????) ?????????. ??? ?????????, ?????? ???????? PPAR-g ? ???? ??????? ???????? 140-??????? ????????? PPAR-g.1 ??????????? ????? ??? ???????????? ???, ??????? ??????? ????????? PPAR-g ? ????? ?????? ?????????????, ??????? ????? ??????? ? ??????????????? ???????? (1�5 ?????/?).1 ????? ???????, ??????????? ????????? ??? ????????? ??????? PPAR-g. Benson SC, Pershadsingh HA, Ho CI et al. Identification of telmisartan as a unique angiotensin II receptor antagonist with selective PPARg-modulating activity. Hypertension 2004;43:993�1002.

40. ??????????? ???????? ???????????????? ? ????????, ? ??????? ?? ????????? ? ??? ???????-?????? ????????????????? ???????????? ???????? 40 ?????????, ?????????? ????????? ??????????????? ???????? ???1 ? ??????? ?????????? ???????????? ???????????.2 ??????? ???????? ??????????? 80 ?? ??? ???????? 50 ?? ? ??????? 3 ???????. ???????????, ? ??????? ?? ?????????, ?????????? (P<0,05) ?????? ??????? ????????? ??????? ?????? (???), ???????????? ?????????? ???????? ?????? (???), ?????? ???????????????? ?????? ?????? ?????????????????????? (HOMA-??) ? ??????? ?????????????????? ??????????? (HBA1c). ??????????? ????? ?????????? ????? ???????? ?????? ?????????????? ??? (P<0,05) ? ??? (p<0,05). World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation. Part 1: Diagnosis and classification of diabetes mellitus. WHO. 1�28. 1999. Vitale C, et al. Metabolic effect of telmisartan and losartan in hypertensive patients with metabolic syndrome. Cardiovasc Diabetol 2005;4:6.? ??? ???????-?????? ????????????????? ???????????? ???????? 40 ?????????, ?????????? ????????? ??????????????? ???????? ???1 ? ??????? ?????????? ???????????? ???????????.2 ??????? ???????? ??????????? 80 ?? ??? ???????? 50 ?? ? ??????? 3 ???????. ???????????, ? ??????? ?? ?????????, ?????????? (P<0,05) ?????? ??????? ????????? ??????? ?????? (???), ???????????? ?????????? ???????? ?????? (???), ?????? ???????????????? ?????? ?????? ?????????????????????? (HOMA-??) ? ??????? ?????????????????? ??????????? (HBA1c). ??????????? ????? ?????????? ????? ???????? ?????? ?????????????? ??? (P<0,05) ? ??? (p<0,05). World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation. Part 1: Diagnosis and classification of diabetes mellitus. WHO. 1�28. 1999. Vitale C, et al. Metabolic effect of telmisartan and losartan in hypertensive patients with metabolic syndrome. Cardiovasc Diabetol 2005;4:6.

41. ??????????? ???????? ?????????? ????????? ?????? ?? ????????? ? ???????????? ? ??? 1-???????? ???????????? ???????? 119 ??????? ? ???????? ???????? 2 ???? ? ?????? ???????????? ???????????, ??????? ???????? ??????????? 40 ??, ?????????? 600 ?? ??? ???????.1 ??????????? ?????????? ????? ???????? ?????? ?????????? ??? ?? ????????? ? ???????????? (p<0,05), ??????? ???????? ??? ??????????? ?? ???????????. ??????????? ????? ?????????? ??????? ?????????? ????????? ??????? ?? ????????? ? ????????????. Derosa G, et al. Effects of telmisartan compared with eprosartan on blood pressure control, glucose metabolism and lipid profile in hypertensive, type 2 diabetic patients: a randomized, double-blind, placebo-controlled 12-month study. Hypertens Res 2004;27:457�464. ? ??? 1-???????? ???????????? ???????? 119 ??????? ? ???????? ???????? 2 ???? ? ?????? ???????????? ???????????, ??????? ???????? ??????????? 40 ??, ?????????? 600 ?? ??? ???????.1 ??????????? ?????????? ????? ???????? ?????? ?????????? ??? ?? ????????? ? ???????????? (p<0,05), ??????? ???????? ??? ??????????? ?? ???????????. ??????????? ????? ?????????? ??????? ?????????? ????????? ??????? ?? ????????? ? ????????????. Derosa G, et al. Effects of telmisartan compared with eprosartan on blood pressure control, glucose metabolism and lipid profile in hypertensive, type 2 diabetic patients: a randomized, double-blind, placebo-controlled 12-month study. Hypertens Res 2004;27:457�464.

42. ????????? ???????????? ???????? ???????? ? ???????? ???????? ST ??????????? ????????? ??????? ????????????????? Hb < 7% ?????????? ????????????????? ??????? ?? ?????????? ?????????? ??? ???????????? ? ?????????? ???????? ??????? ????? ???????, ??? ????????? HbA2. ??????? ?????? ???????? ????? (???????? ????, ?????????? ??????????, ???????????? ????????, ??????? ??)

43. ??????? ??????? ????? ????????? ? ????-???????????????

45. Cumulative Incidence of Recurrent Myocardial Infarction or Death from Coronary Causes, According to the Achieved Levels of Both LDL Cholesterol and CRP. The median value of each marker is included for the sake of completeness, since no patient had the exact median value of either marker. Cumulative Incidence of Recurrent Myocardial Infarction or Death from Coronary Causes, According to the Achieved Levels of Both LDL Cholesterol and CRP. The median value of each marker is included for the sake of completeness, since no patient had the exact median value of either marker.

46. ?????????? ?????? ??? ????? 1,8 ?????/? ?????????? ?????? ?? ??? ????? 2 ??/?

47. ???????? ????????

48. ???????, ?? ??????? ??????? ? ????????? ???????? ?????? ?????????? ?? ??????????? ??????? ???????? ??????????? ?????????? ?????????. ???????, ??? ???????? ?? ?????????, ???????? ??????????????. ??????? �???????? ? ?????????, ???? ?? ????????�, ??????????????? ??????????, ??????????? ????????? ?????????. ??????? ??????? ???????? ? ??????? ????????????? (??????, ???????? ??????????????, ????? ? ?.?.) ????????????????? ? ????????????? ??????? ????????? ?? ??????? (??????????? ?????????????? ??????? ? ?.?.).

49. ???????, ?? ??????? ??????? ? ????????? ???????? ?????? ?????????? ?? ??????????? ??????? ????? �??? ??????????? ?????? ?? ?????? ?????? ???????�, ????????? ?? ?????????? ??????????? ????????. ?????? ?????????? ? ?????????????? ? ???????, ???????? ????????? ?????????? ???????? ? ??????? ????????? ? ?????? ??? ????????. ??????? ???????????? ????????????? ? ???????? ?????: ?? ????? ????? ??: ??????? ? ???????? (???????? ???????); ???????; ??????????? ??? ??????????? ?????? ??? ??????????? ??????????????? ????? ????? (???????? ??????? ? ????????? ?????).

50. ??????????? ??????????????? ??????? ????? ????????????? ?? ????????????? ? ?????????? ????? ??????