Psychosocial risk factors in cardiac practice

Cardiovascular diseases (CVD) remain the leading cause of death in Russia. Apart from conventional modified risk factors, population health, including CVD progression and related death, is influenced by psychosocial risk factors (PS RF). In theory, the role of PS RF can be explained by the significant changes in death rates within the Russian population during social and economic alterations. However, the significance of primary CVD RF has remained unchanged since the Soviet times. Nonetheless, PS RF does not receive much attention in our country. Thus, the current review aimed to introduce specialists focusing primarily on PS RF, such as low socioeconomic status, social isolation and low levels of social support, depressive disorders and personality traits (hostility and type D personality), which are now undoubtedly closely associated with unfavourable prognosis in patients with CVD. This summary also discusses the main pathophysiological mechanisms that may facilitate the progression of CVD, which include the activation of the hypothalamic-pituitary-adrenal axis, sympathoadrenal system with increased cardiovascular reactivity, endothelial function, inflammatory markers, platelets, coagulation factors, fibrinogen and lifestyle-associated factors. Thus, PS RF have considerable practical significance, not only for individual risk estimation but also in primary and secondary interventions for the prevention of CVD.