Does the level of psychological stress affect the death risk in the Russian population. Results of ESSE-RF and ESSE-RF2

Aim. To study the associations of psychological stress (PS) with the risk of fatal and non-fatal events depending on anamnestic features in the Russian population.

Material and methods. Representative samples of the population aged 25-64 years were examined within the ESSE-RF and ESSE-RF2 and included in the prospective cohort (15 regions, n=23815, median follow-up — 7,6 years) were analyzed. PS was assessed using the Perceived Stress Scale-10. PS levels are defined as follows: low — 0-11, moderate — 12-19, high — 20-40. The endpoints were all-cause death and composite endpoint (fatal and/or non-fatal cardiovascular events (CVEs)). Statistical analysis was performed in R 4.2.

Results. In multivariate analysis, high PS level was associated with a 1,45-fold increase in the risk of all-cause death (p<0,001), and a 1,4-fold increase in the risk of fatal and/or non-fatal CVEs (p=0,001). A history of noncommunicable diseases (NCDs) is an aggravating factor for individuals with high PS levels in relation to the risk of fatal and/or non-fatal CVE — among participants with NCDs, the association of PS and prognosis was stronger than among participants without NCDs (p=0,023). At the same time, the number of NCDs did not change the association of PS and prognosis.

Conclusion. The negative impact of PS on the prognosis in the Russian cohort emphasizes the importance of its detection and correction within preventive examinations of the population, as well as the management of patients with NCDs. Inclusion of these positions in regulatory documents will optimize patient routing and reduce the risk of adverse outcomes in the population.

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