Trait anxiety, awareness, health attitudes and 16-year hazard ratio of acute cardiovascular disease in open female population in Russia

Abstract

Anxiety is an independent risk factor for cardiovascular diseases (CVD). Objective of the study was to 
elucidate impact of trait anxiety on hazard ratios (HRs) of acute myocardial infarction (AMI) and stroke in 
open population of 25-64year old women in Russia. Representative sample of female residents (n=870) of 
Novosibirsk was examined according to WHO MONICA-Psychosocial program. First-time AMI and stroke 
events were studied in the cohort from 1994 to 2010. Trait anxiety was evaluated by Spielberger’s test. Cox 
proportional hazards regression model was used to determine HRs for CVD. Prevalence of high level of trait 
anxiety (HLA) was 60%. Poor self-rated health was associated with HLA. HLA group had higher levels of 
stress at workplace and in family. Increased trait anxiety was associated with worse behavioral risk profile 
related to smoking, diet and physical activity. Women with HLA had 4.2-fold (p=0.05) and 3.5-fold (p<0.05) 
increases in AMI and stroke HRs, respectively. Among women with HLA, increased MI and stroke rates 
were associated with married marital status, lower education levels and physically demanding jobs. 
Integrated analysis of epidemiological traits in CVD psychosocial risk factors allowed to identify 
pathogenetic mechanisms providing background for prevention.