[Arterial hypertension in extreme situations].

Wartime arterial hypertension (AH) is AH that debuts or changes its character under the influence of specific wartime factors or military labor. The features of wartime AH were determined. They included the following: AH incidence during war grows; AH incidence in the battlefront servicemen is higher than in those who serve on the home front; there is a direct correlation between AH prevalence and how often the person participates in the battles; the patients are relatively young. Acute AH forms usually debuted as a result of extremely strong of lingering stressful factors. Acute AH development was characteristic of subjects having family predisposition to hypertensive reactions. The clinical picture of acute AH had features of a hypertensive crisis, frequent complications of which were acute cardiac insufficiency and/or acute hypertensive encephalopathy, which required urgent medical aid. AH was resistant to pharmacotherapy. Further on, high AH level remained, crises occurred, and lesions of target organs progressed. The features of AH in military operators were characterized by medium, high, and very high risk of complications. II and III degrees of AH prevailed. The main risk factors in patients with workplace arterial hypertension (WAH), in addition to emotional tension, often were smoking, family background, hyperlipidemia, excessive body weight (metabolic syndrome). In 87% of patients with WPAH behavioral type A was revealed, mostly with medium or prominent elevation of the level of personal, reactive, and total anxiety. Persons with prognostically unfavorable 24-hour profiles of BP--non-dippers and night-peakers--prevailed (p < 0.001). Imidazoline receptor agonists (moxonidine) in patients with WAH normalized BP level. Twenty-four-hour BP profiles became normal in 90% of the WAP patients. Positive antihypertensive effects of moxonidine in patients with WAP become clear after 12 weeks of drug application; the psychological status becomes normal too.