Pogosova N V, Boitsov S A, Oganov R G, Kostyuk G P, Sokolova O Yu, Yufereva Yu M, Kursakov A A, Ausheva A K, Vygodin V A, Karpova A V, Arutyunov A А, Isakova S S
National Medical Research Center for Preventive Medicine.
Kardiologiia. 2018 Nov 23;58(11):5-16. doi: 10.18087/cardio.2018.11.10193.
Psychosocial (PS) risk factors (RF) make a substantial contribution in populational burden of cardio-vascular diseases (CVD) and their complications.
The KOMETA (Comet) study was directed to obtaining actual information on PSRF among ambulatory patients with arterial hypertension (AH) and / or ischemic heart disease (IHD) in 30 cities of Russian Federation.
This multicenter cross-sectional study was conducted in 2016-2017. Doctors participating in the study (n=325) recruited in state polyclinics 2775 patients aged ≥55 years with AH and / or IHD. Information collected from these patients comprised social-demographic and clinical characteristics, data on RF, adherence to therapy. Assessment of PSRF was carried out with consideration of levels of anxiety, depression and stress, presence of personality type D.
Population of patients studied (72 % women) was characterized by considerable prevalence of PSRFs. Low levels of education and income were found in 24.5 and 44.2 % of patients, respectively; 25.2 % of patients reported living alone, 6.3 % - felt social isolation. Elevated, extremely high levels of stress, type D personality were detected in 67.8, 10, and 37.6 % of patients, respectively; clinically significant symptoms of anxiety and depression were found in 25.5 and 16.3 %, respectively. Most RFs were significantly more often detected in women, and older people. One third of patients (33.1 %) during a year preceding inclusion took some psychotropic drugs mainly herbal or barbiturate-containing (27.1 %). Moreover, 30 % of patients had lowering of cognitive functioning.
In this large-scale study we revealed high prevalence of PSRFs among ambulatory patients with AH and / or IHD in Russia. Despite positive dynamics of prevalence of states of anxiety and depression relative to earlier studies in this country their negative impact on prognosis of CVD and quality of life of affected patients requires optimization of efforts for organization of adequate care and directed to timely diagnosis and correction of these states.
心理社会（PS）风险因素在心血管疾病（CVD）及其并发症的人群负担中起重要作用。
KOMETA（彗星）研究旨在获取俄罗斯联邦30个城市中患有动脉高血压（AH）和/或缺血性心脏病（IHD）的门诊患者的PS风险因素的实际信息。
这项多中心横断面研究于2016 - 2017年进行。参与研究的医生（n = 325）在国立综合诊所招募了2775名年龄≥55岁的患有AH和/或IHD的患者。从这些患者收集的信息包括社会人口统计学和临床特征、风险因素数据、治疗依从性。PS风险因素的评估考虑了焦虑、抑郁和压力水平以及D型人格的存在。
所研究的患者群体（72%为女性）的特点是PS风险因素的患病率相当高。分别有24.5%和44.2%的患者受教育程度低和收入低；25.2%的患者报告独居，6.3%的患者感到社会孤立。分别有67.8%、10%和37.6%的患者检测到压力水平升高、极高，以及D型人格；分别有25.5%和16.3%的患者有临床上显著的焦虑和抑郁症状。大多数风险因素在女性和老年人中更常被检测到。三分之一的患者（33.1%）在纳入研究前一年服用了一些精神药物，主要是草药或含巴比妥酸盐的药物（27.1%）。此外，30%的患者认知功能下降。
在这项大规模研究中，我们发现俄罗斯患有AH和/或IHD的门诊患者中PS风险因素的患病率很高。尽管与该国早期研究相比，焦虑和抑郁状态的患病率有积极变化，但它们对CVD预后和受影响患者生活质量的负面影响需要优化组织适当护理的努力，并致力于这些状态的及时诊断和纠正。
