Abstract
More than 10 years passed since conduction of the first clinical-epidemiological study of prevalence of psychosocial risk factors (PSRF) in patients with arterial hypertension (AH) an/or ischemic heart disease in Russian Federation. to assess current prevalence of PSRF in patients with AH/CHD and their relationship with traditional risk factors. Patients with verified AH and/or CHD aged ≥55 years were included into this cross-sectional study in 30 cities of Russia representing 7 federal districts according to the following procedure. In each city we selected 2-5 federal clinics - providers of primary medical care; in each of these clinics we at random invited 2-5 physicians to take part in this study. Each of these physicians for 1-2 days included 10 consecutive patients with AH and/or CHD. Information collected from patients comprised social demographic and clinical characteristics, risk factors, adherence to therapy; Hospital Anxiety and Depression Scale (HADS) was applied for detection of symptoms of anxiety and depression. Obtained information was used for analysis of prevalence of cardiovascular risk factors and their association with symptoms of depression and anxiety in a framework of Pearson linear and Kendall rank correlation analysis. Symptoms of anxiety of various severity (HADS-A≥7) were detected in 42.2% of patients with AH and/or CHD, in 25.5% they were clinically significant (HADS-A≥11). Symptoms of depression of various severity (HADS-D ≥7) were detected in 42.5% of patients with AH and/or CHD, in 16.3% they were clinically significant (HADS-D≥11). We also observed several significant associations of symptoms of depression and anxiety with traditional cardiovascular risk factors: low level of physical activity, elevated systolic and diastolic arterial pressure, level of total cholesterol, abdominal obesity; some unhealthy nutritional habits. Prevalence of symptoms of anxiety and depression was found to be high among ambulatory patients with AH and/or CHD. However, in this study it was lower compared with that reported by previous studies in Russia.
Highlights
В каждом городе для участия в исследовании случайным образом отбирали от 2 до 5 типовых государственных медицинских учреждений, оказывающих первичную медико-санитарную помощь, в каждом из которых для участия в исследовании приглашали 2–5 участковых врачей или врачей общей практики, работающих на полную ставку в этих должностях (т. е. выполняющих соответствующие обязанности в полном объеме)
More than 10 years passed since conduction of the first clinical-epidemiological study
CHD aged ≥55 years were included into this cross-sectional study in 30 cities
Summary
More than 10 years passed since conduction of the first clinical-epidemiological study of prevalence of psychosocial risk factors (PSRF) in patients with arterial hypertension (AH) an / or ischemic heart disease in Russian Federation. Имеется большое число проспективных исследований, а также систематических обзоров и мета-анализов, свидетельствующих о том, что наличие депрессивной симптоматики у исходно здоровых лиц увеличивает последующий риск развития ишемической болезни сердца (ИБС) в 1,5–4,5 раза [4, 5]. Наличие тревожной / депрессивной симптоматики у больных АГ / ИБС при исходном обследовании в 1,5–2 раза увеличивало риск развития сердечно-сосудистых катастроф и смерти за 1,5и 3‐летний период наблюдения. Целью исследования явилась оценка распространенности психосоциальных ФР развития ССЗ у больных АГ / ИБС, их взаимосвязи с традиционными ФР и влияния на прогноз, а также выработка оптимальной тактики ведения пациентов с АГ / ИБС, направленной на повышение качества жизни больных и предотвращение сердечно-сосудистых осложнений. В исследование включали пациентов в возрасте 55 лет и старше с верифицированной АГ и / или ИБС.
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