Do psychosocial factors increase the risk of cardiovascular death and acute myocardial infarction in adults aged 25-64 years?
Psychosocial factors, including low education, marital status, anxiety, and depression, significantly contribute to the long-term risk of cardiovascular death and myocardial infarction in the active working population.
Purpose of the study: based on a longitudinal study, to assess the contribution of psychosocial factors to survival and the risk of developing cardiovascular diseases (CVD) among people 25–64 years old in Siberia (Novosibirsk, Tyumen, Tomsk). Materials and methods. On the basis of Research Institute of Therapy and Preventive Medicine – branch of the Federal State Budgetary Scientific Institution «Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences», Tyumen Cardiology Research Center – branch of the Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center of the Russian Academy of Sciences», Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center of the Russian Academy of Sciences» using the standard protocol for cardiac screening programs: «Study of the prevalence of coronary artery disease, risk factors for coronary artery disease in various regions of the country»; WHO «MONICA», which did not differ significantly, as well as the «MONICA-psychosocial» subprogram to identify psychosocial risk factors for cardiovascular diseases, cross-sectional studies were conducted on random representative samples of people 25-64 years old: Tomsk – 1981–1982 ( n = 738 men); 1985–1986 ( n = 1148 men); 1994–1995 ( n = 637 men – postal survey and n = 450 men – cardiac screening); Tyumen – 1996 (795 men and 813 women); Novosibirsk – 1994 (657 men and 870 women). The cohort in Tyumen was observed for 12 years, in Tomsk for 19 years, and in Novosibirsk for 16 years. The following «end points» were recorded: death from ischemic heart disease (IHD), CVD, new-onset acute myocardial infarction (AMI) using the WHO program «Acute Myocardial Infarction Registry». Results. Among men and women 25-64 years old in Tyumen, a high 12-year relative risk of cardiovascular death was established in persons with a low level of education, in the professional group of heavy physical labor; in the male cohort – among single, widowed and divorced men. An assessment of the attributable risk of the social gradient in the male cohort showed the greatest contribution to cardiovascular death from the group of widows – 69.2 %, in the female cohort – from the group of people with a low level of education – 84.0 %. For men 25–64 years old in Tomsk, prognostically significant parameters of the social gradient of attributable risk are ranked as follows: 1) for mortality from IHD – working professions, lack of a permanent life partner, low level of education; 2) for mortality from CVD – working professions, average level of education, lack of a permanent life partner, low level of education. Among men and women aged 25–64 years in Novosibirsk, high levels of anxiety, depression and low levels of social support became prognostically significant risk factors for AMI for men and women; among men there is a high level of vital exhaustion. Conclusions. It was established that in the high: 12-year relative risk, 19-year attributable risk of cardiovascular death, the social gradient is prognostically significant. Anxiety, depression, vital exhaustion, social support play a leading role in predicting CVD in the Siberian region among the active working population.
Гафаров et al. (Wed,) studied this question.