1. Adaptogens in normalization of hemodynamic parameters in meteosensitivity patients with arterial hypertension and ischemic heart disease with taking into account an influence of the earth and cosmic weather Shcherban E.A., Zaslavskaya R.M. Belgorod city university, Belgorod; City clinic hospital N60, Moscow.

2. Actuality There are some reasons, impeding to end aim achievement of hypotensive treatment. One of them is meteodependence. 1/3 of men and ½ of women are sensitive to weather changes. 65-75% patients with cardiovascular diseases suffere from painful meteosensitivity. 10-13% people of earth suffer from magnetic storms. 2/3 of all strokes and infarcts takes place in these dangerous days. In magnetic storm infarcts number increase by 76,4%; strokes number – by 30,8%.

3. Actuality Investigation of meteo- and magnitosensitivity in patients with arterial hypertension (AH) and ischemic heart disease (IHD) as well as search in pharmacological defence from pathologic influence of weather on hemodynamics is actuality.

4. The aim of present work are: to study influence meteorological and geomagnetic activity on hemodynamic parameters in patients with different level of arterial blood pressure (ABP), including AH with IHD. to investigate meteoprotective action of drugs with adaptogenic properties (melaxen, mebicar, eltacin).

5. The objectives of investigation are: 1.to study correlations between weather factors and main hemodynamic parameters in patients with normal, decreased and increased ABP. 2.to investigate correlations dependence between meteorological, geomagnetic factors and basic hemodynamic parameters in patients with AH stage II-III, grade II-III in complex with IHD of the background traditional therapy (TT) as well as in include in TT drugs with adaptogen activity (melaxen, mebicar, eltacin).

6. The objectives of investigation are: 3. to examine TT on ABP 24-hours monitoring (24hMBP), echocardiography (EchoCG) and transcranial dopplerography (TCDG) of cerebral vessels with taking into account influence of meteorological and geomagnetic factors on hemodynamics in patients with AH stage II-III, grade II-III in complex with IHD. 4. to study influence of melaxen, mebicar and eltacin on the background of TT on 24hMBP, EchoCG parameters and TCDG of cerebral vessels with taking into account meteo- and magnitosensitivity in patients with AH stage II-III, grade II-III in complex with IHD.

7. General characteristics of examined patients Patients with different level of BP 1 group pts with normal or decreased BP level 2 group pts with small increased BP level 3 group pts with AH, grand II-III All patients141316 Men from them453 Women from them10813 Middle age, y.o.51,2±1,4 лет50,1±1,6 лет55,3±1,9 лет ABP level (mm Hg) less 129/84 14-- High normal BP (not more 139/89) -10- АH grad I (not more 159/99)-3- АH grad II (not more 179/109)--7 АH grad III (not more 180/110)--9

8. General characteristics of examined patients Pts with AH and IHD 4 group of pts, obtained ТТ 5 group of pts, receiving melaxen on the basis of TT 6 group of pts, receiving mebicar on the basis of TT 7 group of pts, receiving eltacin on the basis of TT All patients3836 35 Men from them15191118 Women from them23172517 Middle age, y.o.58,6±1,555,5±1,463,5±1,561,1±1,8 АH, grad II25281213 АH, grad III1382422 АH, stage I247- АH, stage II22252218 АH, stage III147717 Stenocardia efford29281824 Postinfarction cardiosclerosis 1615912

9. Traditional therapy -adrenoblockers (atenolol 25 mg 2 times a day) calcium antagonists (verapamil 40 mg 3 times a day) ACE- ingibitors (enap 5 mg 2 times a day) antiagregants (aspirin 125 mg a day in the evening) diuretics (hypotiazid 12,5 мг in the morning) nitrates (monocinque 20 mg 2 times a day)

10. Adaptogens Melaxen (melatonin, «Unipharm, Inc.», USA) 3 mg at 22.00 Mebicar («Таtchempharmdrugs») 0,3 mg 3 times a day Eltacin (Science institute of citochemia and molecular pharmacology, Moscow) – complex amino acids – glicin, glutamin acid, cistin 220 mg 3 times a day.

11. Instrumental methods of investigation BP and HR examination in the morning and evening during 3 weeks 24-hours monitoring BP Echocardiography Transcranial dopplerography cerebral vessels.

12. Weather factors air temperature atmospheric pressure relative humidity dew point cloudiness direction and velocity of wind geomagnetic activity index (Кр-index) Data of meteofactors were obtained from server «Russian weather» (meteo.infospace.ru).

13. Results of investigations Correlation between BP and weather factors (р<0,05)

14. Correlations between BP and Kp-index (р<0,05)

15. 24-hours MBP SBP, mm Hg DBP, mm Hg Grad of night depression SBP, % Grad of night depression DBP, % ТТ+ from 152,4±5,0 to 130,5±2,7 (р<0,001) --- Melaxen on the basis of TT + from 144,1±2,7 to 128,6±2,5 (р<0,001) + from 89,3±1,9 to 79,8±1,8 (р<0,001) + from 7,5±1,3 to 12,8±1,0 (р<0,002) + from 10,8±1,6 to 19,0±1,2 (р<0,001) Mebicar on the basis of TT + from 154,1±3,9 to 129,9±3,0 (р<0,001) + from 97,6±2,7 to 82,1±1,8 (р<0,001) -- Eltacin on the basis of TT + from 151,5±4,0 to 126,7±4,5 (р<0,001) + from 97,1±3,7 to 80,6±2,7 (р<0,001) --

16. Correlations between 24-hours MBP parameters and weather factors (р<0,05)

17. Correlations between 24hMBP parameters and Kp-index (р<0,05)

18. Correlations between EchoCG parameters and weather factors (р<0,05)

19. Correlations between EchoCG parameters and Kp-index (р<0,05)

20. Dynamics of EchoCG parameters in TT with take into account meteofactors Before treatmentAfter treatmentР ESD, сm 3,6±0,053,5±0,040,04 ESV, ml54,3±1,752,7±1,50,04 Е/А0,68±0,040,73±0,030,05 Before treatmentAfter treatment Influence on parametersmiddle cloudiness, atmosphere pressure, wind velocity middle cloudiness, atmosphere pressure, wind direction and velocity The most sensitive to meteofactors Е/АPeak Е, Е/А. There are no correlations to ESV

21. Dynamics of EchoCG parameters in therapy of melaxen with taking into account meteofactors Before treatmentAfter treatmentР ESD, cm 3,6±0,033,5±0,030,01 ESV, ml54,7±0,750,7±1,10,002 EF, %56,2±0,858,3±1,00,03 TPVR, din/s/cm-51715,6±65,11478,8±65,00,001 SPVR, din/s/cm-5/m2909,8±34,9801,4±29,20,001 Peak Е, m/с0,47±0,010,51±0,010,02 Peak А, m/с0,69±0,030,65±0,030,04 Е/А0,72±0,040,83±0,040,005 Before treatmentAfter treatment Influence on parameters Lower cloudiness, wind direction atmosphere pressure, middle cloudiness; Influence of lower cloudiness, wind direction, geomagnetic activity are decreased. The most sensitive to meteofactors All parameters are equalPeak Е, There are no correlations to ESD, peak А.

22. Dynamics of EchoCG parameters in therapy of mebicar with taking into account meteofactors Before treatmentAfter treatment Р ESD, cm 3,53±0,043,48±0,030,05 ESV, ml51,4±1,549,8±1,40,03 TPVR, din/s/cm-51756,1±74,71603,6±65,70,009 SPVR, din/s/cm-5/m2921,9±37,5853,4±33,70,009 Peak Е, m/с0,48±0,020,52±0,010,02 Е/А0,79±0,050,90±0,050,02 IVRT, mc110,8±1,4107,9±1,70,04 Before treatmentAfter treatment Influence on parameters wind direction and velocityatmosphere pressure, upper cloudiness; Influence of wind direction and velocity, geomagnetic activity are decreased. The most sensitive to meteofactors EF, DFLV paramrtres ESD, EF, peak Е, IVRT

23. Dynamics of EchoCG parameters in therapy of eltacin with taking into account meteofactors Before treatmentAfter treatment Р ESD, cm 3,47±0,043,39±0,040,01 ESV, ml50,7±1,046,7±0,90,001 EDV, ml118,9±2,1115,4±1,70,04 EF, %57,3±0,859,3±0,90,04 MVC, l/min 5,7±0,25,1±0,20,007 CI, l/min/m2 3,1±0,12,8±0,10,01 Peak Е, m/с0,52±0,020,57±0,020,03 Before treatmentAfter treatment Influence on parameters Wind velocityInfluence of all meteofactors, the most grad - atmosphere pressure, wind velocity are decreased The most sensitive to meteofactors All parameters are equal, the most peak Е ESD, ESV, EDV, EF, МVС, СI, peak Е

24. Correlations between TCDG parameters and weather factors (р<0,05)

25. Dynamics of TCDG parameters in TT with take into account meteofactors Before treatmentAfter treatmentР Ved (l), см/c 29,8±0,631,6±0,80,02 TAMAX (l), см/c50,8±0,650,8±0,654,2±1,40,01 Before treatmentAfter treatment Influence on parameterscloudinesslower cloudiness, wind direction The most sensitive to meteofactors right MCA parametersleft MCA parameters, Number of correlations with right MCA parameters are decreased.

26. Dynamics of TCDG parameters in therapy of melaxen with taking into account meteofactors Before treatmentAfter treatment Р Vps (l), см/c 91,6±1,295,2±1,70,05 Ved (l), см/c42,3±1,245,1±1,00,04 Ved (r), см/c37,8±0,840,6±0,90,02 TAMAX (r), см/c59,0±0,961,0±0,90,03 Before treatmentAfter treatment Influence on parameters atmosphere pressure, wind velocity atmosphere pressure, wind velocity The most sensitive to meteofactors The two MCA in equal gradNumber of correlations with left and right MCA parameters are decreased.

27. Dynamics of TCDG parameters in therapy of mebicar with taking into account meteofactors Before treatmentAfter treatment Р Ved (l), см/c39,8±1,042,2±1,00,02 PI (l)0,91±0,030,85±0,030,05 Ved (r), см/c42,4±0,945,0±0,90,02 TAMAX (r), см/c63,0±0,865,0±0,90,03 PI (r)0,90±0,030,85±0,040,05 Before treatmentAfter treatment Influence on parameters atmosphere pressure, wind velocity atmosphere pressure, wind velocity The most sensitive to meteofactors The two MCA in equal grad, more – Ved both MCA Number of correlations with Ved, PI of left and right MCA parameters are decreased.

28. Dynamics of TCDG parameters in therapy of eltacin with taking into account meteofactors Before treatmentAfter treatment Р Vps (r), см/c94,1±1,297,6±1,20,04 Ved (r), см/c32,4±0,634,1±0,70,03 TAMAX (r), см/c61,9±0,663,4±0,80,05 Before treatmentAfter treatment Influence on parameters atmosphere pressure, wind direction Cloudiness, Influence of atmosphere pressure, wind are decreased. The most sensitive to meteofactors left MCA (Vps, PI)Right MCA (indexes), Ved, ТАМАХ of right MCA

29. (+) Adaptogens in correction of influence of weather factors in meteo- and magnetosensitive patients with AH and IHD ТТТТ+ melaxenТТ+ mebicarТТ+ eltacin SBP+ ( influence of dew point) + ( influence of upper cloudiness, geomagnetic activity) +( influence of geomagnetic activity) +( influence of atmospheric pressure, cloudiness) DBP+ ( influence of upper cloudiness, geomagnetic activity) +( influence of geomagnetic activity) +( influence of atmospheric pressure, cloudiness) Systolic function++ ( influence of lower cloudiness, wind direction) +( influence of atmospheric pressure, wind) Diastolic function++ ( influence of lower cloudiness, wind direction, geomagnetic activity) +( influence of wind, geomagnetic activity) Cerebral circulation velocity parameters ++( influence of middle cloudiness, wind) +( influence of wind direction) +( influence of atmospheric pressure, wind) Peripheral cerebral vessels resistance indexes +( influence of cloudiness)

30. Conclusions 1.On the basis of correlation analysis there are established, that patients with normal, decreased and moderate increased ABP are exposed to influence of meteofactors in equal grad; number correlations between BP and weather factors are increased by 3 times in high grad AH. 2.Patients, suffering from AH, stage II-III, grad II-III with IHD and receiving TT, are exposed to influence many weather factors. Including in TT mebicar did not decrease correlations number between BP and weather factors; under the influence melaxen and eltacin influence of weather factors on hemodynamic are decreased. 3.TT in patients with AH, stage II-III, grad II-III with IHD produce hypotensive effect, influencing on SBP; TT exerts antianginal action, positive influencing on systolic and diastolic function of LV, normalizes cerebral blood circulation velocity parameters, but TT does not reduce influence of weather factors on hemodynamics.

31. Conclusions 4. Including in TT melaxen increases hypotensive action of TT, reducing SBP, DBP level, normalizing daily profile of BP, myocardial contractive and relaxing functions of LV improvements, cerebral circulation velocity parameters normalize. There are revealed reduction influence of meteo- and geomagnetic activity on BP and EchoCG parameters. 5. Including in TT mebicar increases hypotensive action of TT, reducing SBP, DBP, influences on diastolic function of LV, normalizes cerebral circulation velocity and indexes peripheral vessel resistance, what are according by reduction of influence of geomagnetic activity on BP and EchoCG parameters, reduction of influence of meteofactors on TCDG cerebral vessel parameters.

32. Conclusions 6. Including in TT eltacin increases TT hypotensive action, decreasing SBP, DBP, myocardial contractive functions of LV improvements, cerebral circulation velocity normalizes. There are reduction of influence of meteofactors on BP and EchoCG parameters. 7. There are revealed meteoprotective action of drugs with adaptogen properties (melaxen, mebicar, eltacin) and magneticprotective action of melaxen and mebicar, which may be used for treatment of meteo- and magnetosensitive patients with AH and IHD.

33. Thank you for your attention