Research Laboratory for AH Pathogenesis and Treatment

Prof. Alexandra Konradi, MD, DSc
Head of Arterial Hypertension Research Department, Head of Laboratory, Corresponding Member of RAS

Objectives

Planning, organizing and conducting research and clinical studies in patients with arterial hypertension, mainly with a high risk of cardiovascular complications in order to provide better and most effective specialized and high-tech medical care for this category of patients.

Major research areas

• Studying the pathogenetic mechanisms of true resistance to therapy in hypertension, including disorders in the neuro-humoral regulation of blood circulation, metabolism, inflammatory markers, elastic-elastic properties of the great vessels.
• Determining the relationship between impaired regulation of peripheral and central blood pressure in patients with aortic aneurysms of various origins and in stenosing atherosclerosis of the brachiocephalic arteries.
• Investigating the role of adipokines in the pathogenesis of arterial hypertension, including in combination with metabolic syndrome.
• Revealing the pathogenetic features of nephrogenic / renovascular and endocrine secondary forms of arterial hypertension
• Studying the role of markers of early renal damage in the pathogenesis of hypertension
• Developing and implementing patient-oriented approaches to the management and treatment of patients with essential hypertension as part of digital health projects.

Clinical work

The specialists of the Laboratory staff provide outpatient and inpatient consultations to patients with various forms of arterial hypertension and at a high risk of cardiovascular complications, including patients with aortic aneurysms, obliterating atherosclerosis of carotid arteries, sleep-disordered breathing and metabolic disorders. Diagnostically and tactically challenging cases are presented for case conferences and case studies. Patients with renovascular arterial hypertension and hormone-producing adrenal tumors are selected for surgical interventions. Laboratory staff carry out long-term dispensary observation of patients with severe resistant course of arterial hypertension, including after surgical interventions. Our laboratory specialists carry out long-term follow-up of patients with severe resistant arterial hypertension, including after surgery.

Training and education

• Postgraduate advanced training course “Resistant Hypertension” (72 hours)
• Postgraduate advanced training course “Prevention and Treatment for Fibrosis of Organs and Tissues in Different Conditions” (72 hours)
• Postgraduate advanced training course “Diagnostic Methods for Vascular Stiffness and Organ and Tissue Fibrosis in Different Conditions” (72 hours)
• Lecture course on the diagnosis and treatment of arterial hypertension as part of the training for interns and residents of Almazov Centre
• Specialized course to be introduced “Diagnosis of uncontrolled arterial hypertension and ways to overcome resistance to antihypertensive therapy” ( 36 hours, for general practitioners, cardiologists, endocrinologists, functional testing specialists and medical sonographers)
• Specialized modules developed as part of the continuing medical education concept in 2020: “Modern algorithms for the diagnosis of resistant arterial hypertension” and “Drug and non-drug treatments for resistant arterial hypertension”

Grants

• Grant from the Russian Science Foundation (2017—2019). “Predictive modeling using big data analysis based on a value-based approach in the diagnosis and treatment of cardiovascular diseases” (extended project term for 2020—2021)
• Presidential Grant for the state support of leading scientific schools of the Russian Federation “Development of personalized approaches to the treatment of arterial hypertension with account of molecular, genetic and cytokine markers, neurogenic effects, organ damage and metabolic disorders”

Clinical testing

• Clinical testing 2018-12-11 “Radiofrequency ablation of the renal sympathetic nerves in patients with resistant arterial hypertension” (2018 -2019).
  Coordinated by: E.N. Mikhailov, I.V. Emelyanov.
  Jointly with the Neuromodulation Research Laboratory, renal sympathetic denervation was performed in 50 patients with resistant arterial hypertension.

Participation in international projects

Artemis Registry — Ambulatory Blood Pressure Registry: telemonitoring of hypertension and cardiovascular risk project. Project Coordinator – Professor Gianfranco Parati.

Global SYMPLICITY Registry — International Registry of 3-5-year prospective study of patients selected for sympathetic renal denervation.

MASTER STUDY – MASked-unconTrolled hypERtension management.

VASOTENS Registy – Vascular Health Assessment of The Hypertensive Patients.

PRECISION trial to assess the efficacy and safety of Aprocitentan in patients diagnosed with resistant arterial hypertension.