Stress-related emotional disturbances in patients with cardiovascular diseases

Abstract

Acute and chronic stress, as well as emotional disturbances as a consequence of stressful situations, are significant risk factors for the development and progression of some of acute and chronic non-communicable diseases, including cardiovascular diseases (CVD), among which the most common are arterial hypertension, chronic heart failure and atherosclerotic CVD. Specific emotional disturbances that arise after exposure to significant traumatic or stressful situations include acute and post-traumatic stress disorder. When a stress factor does not reach high intensity or significance, adjustment disorder may develop. Stress-related emotional disturbances significantly affect other CVD risk factors, reduce patients’ adherence to healthy lifestyle changes and drug therapy, deteriorate quality of life and increase the risk of disability. The urgency of identifying and managing post-stress emotional disturbances in the practice of internists is caused by high frequency of these disturbances in outpatient patients. It is especially important to manage and prevent these disturbances in patients with CVD due to increased number of adverse outcomes resulting from this combination. Treatment of emotional disturbances resulting from stressful situations includes both drug and non-drug methods. Antidepressants and benzo-diazepine anxiolytics are the main classes among the drugs used to treat post-stress emotional disorders. However, the prescription of these drugs requires taking into account a wide range of possible side effects, especially in patients with CVD. The choice of drugs with a favourable safety profile and a rapid onset of sedative and anti-anxiety effects is a key element in the modern effective patient management strategy. Tofisopam and buspirone are the most advanced of this group of drugs in therapeutic and cardiological practice.