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Stress, Anxiety and Depressive Symptoms are Predictors of Worse Outcomes in Outpatients With Arterial Hypertension and Coronary Heart Disease: Results of 1.5 Years Follow-up From the COMETA Multicenter Study.
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- Author(s): Pogosova NV;Pogosova NV;Pogosova NV; Ausheva AK; Ausheva AK; Ausheva AK; Saner H; Saner H; Boytsov SA; Boytsov SA
- Source:
Kardiologiia [Kardiologiia] 2023 Dec 26; Vol. 63 (12), pp. 3-10. Date of Electronic Publication: 2023 Dec 26.- Publication Type:
Multicenter Study; Journal Article- Language:
Russian; English - Source:
- Additional Information
- Source: Publisher:
OOO "Obshchestvo spet︠s︡ialistov po serdechnoĭ nedostatochnosti Country of Publication: Russia (Federation) NLM ID: 0376351 Publication Model: Electronic Cited Medium: Print ISSN: 0022-9040 (Print) Linking ISSN: 00229040 NLM ISO Abbreviation: Kardiologiia Subsets: MEDLINE - Publication Information: Publication: <2017->: Moskva : OOO "Obshchestvo spet︠s︡ialistov po serdechnoĭ nedostatochnosti"
Original Publication: Moskva. - Subject Terms: Hypertension*/complications ; Myocardial Ischemia*/complications ; Myocardial Ischemia*/diagnosis ; Myocardial Ischemia*/epidemiology ; Coronary Disease*/complications ; Coronary Disease*/diagnosis ; Coronary Disease*/epidemiology; Male ; Humans ; Middle Aged ; Aged ; Female ; Prospective Studies ; Depression/diagnosis ; Depression/epidemiology ; Depression/etiology ; Follow-Up Studies ; Outpatients ; Anxiety/diagnosis ; Anxiety/epidemiology ; Anxiety/etiology
- Abstract: Aim To study associations between the risk of severe adverse cardiovascular outcomes (SACVO) and all-cause death with psychosocial risk factors (PS RFs), such as stress, anxiety and depressive symptoms, low level of education, low income, social isolation, and type D personality, in patients with arterial hypertension (AH) and ischemic heart disease (IHD) managed in primary health care institutions in a multi-year prospective study.Material and methods PS RFs were assessed in patients with AH or IHD, who participated in a multi-year prospective COMETA study, using the Hospital Anxiety and Depression Scale (HADS), DS-14 questionnaire, and a visual analogue scale (VAS) for assessment of stress level. Associations of PS FRs with SACVO and all-cause death after a 1.5-year follow-up were analyzed using multivariate Cox regression models.Results At 1.5 years after patients were included in the study, it was possible to obtain data for 2,538 patients (age at baseline, 66.6 ± 7.8 years, 28.1% men), 106 of whom died during that period. The incidence of SACVO was 40.0 per 1000 person-years. According to the results of multivariate regression analysis, a very high level of anxiety symptoms (HADS-A≥14) was significantly associated with SACVO (odds ratio (OR), 1.81; 95% confidence interval (CI), 1.04-3.15; p=0. 02). The composite endpoint that included all-cause death and/or SACVO was significantly associated with a high (VAS score ≥8) stress level (OR, 1.53; 95% CI, 1.00-2.33; p=0.04) and a very high (HADS-D≥14) level of depressive symptoms (OR, 2.11; 95% CI, 1.22-3.62; p=0.02). A low level of education adjusted for gender and age increased the likelihood of SACVO by 1.7 (95% CI, 1.19-2.43) times. No significant associations were found between the analyzed outcomes and type D personality or with social isolation.Conclusion In patients with AH or IHD, the presence of high-grade stress and severe depressive symptoms increased the likelihoods of all-cause death and SACVO while a low level of education and severe anxiety symptoms were associated with SACVO. The study results showed that PS RFs for cardiovascular diseases keep the PS RF prognostic significance in the conditions of modern treatment of AH and IHD. Due to the negative impact on the prognosis, PS RFs should be taken into account when taking measures for secondary prevention of AH and IHD.
- Publication Date: Date Created: 20231229 Date Completed: 20240101 Latest Revision: 20240101
- Publication Date: 20240102
- Accession Number: 10.18087/cardio.2023.12.n2564
- Accession Number: 38156484
- Source:
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