Gender differences of hypertension risk in population with the high level of personal anxiety in Russia/Siberia (WHO program «MONIC A-psychosocial)

Objective. To determine the gender differences influence of personal anxiety (PA) in the risk of hypertension development in the open population aged 25–64 years old in Russia/Siberia.

Design and methods. As part of the G program III WHO “MONICA-psychosocial” a random representative sample including both sexes aged 25–64 years old was surveyed in Novosibirsk in 1994 (males: n = 657 44,3 ± 0,4 years, response — 82,1 %; women: n = 689, 45,4 ± 0,4 years, response — 72,5 %). The survey included registration of socio-demographic data, and assessment of PA (test Spielberger CD, 1972). During 16‑year follow-up 229 cases of new-onset hypertension (HTN) among women and 46 cases among men were identified.

Results. In an open population of 25–64 high level of anxiety (HLA) was detected in 59,9 % of women and 50,9 % men. After 5 years, in population aged 25–64 years old the hazard risk (HR) of HTN development was higher in men (HR = 5) than in women (HR = 2,3) in the presence of HLA; the same results were found in 10 years. However, when considering subgroups, women aged 55–64 years old with HLA had higher HTN risk (10‑fold) than men (7,9‑fold) in 10 years. Multivariate Cox regression analysis showed that HLA had the greatest impact on the risk of HTN in female population aged 55–64 years old (HR = 7,9); among men, HLA is associated with the higher HTN risk in divorced (HR = 4,3) and widowed (HR = 4,8) subjects, and in males aged 55–64 years old (HR = 5,5).

Conclusion. We found greater prevalence of HLA traits in women compared to men. At the same time the risk of HTN is higher in men with HLA than in women aged 25–64 years, except for the older age groups. 

1. Бритов А. Н., Быстрова М. М. Стресс-индуцированная АГ. Профилактика заболеваний и укрепления здоровья. 2003;5:34–40. [Britov AN, Bystrova MM. Stress-induced hypertension. Disease prevention and health promotion. 2003;5:34–40. In Russian].

2. Шальнова С. А., Баланова Ю. А., Константинов В. В., Тимофеева Т. Н., Иванов В. М., Капустина А. В. и др. Артериальная гипертония: распространенность, осведомленность, прием анти-гипертензивных препаратов и эффективность лечения среди населения Российской Федерации. РКЖ. 2006;4:45–50. [Shalnova SA, Balanova YuA, Konstantinov VV, Timofeeva TN, Ivanov VM, Kapustina AV et al. Hypertension: prevalence, awareness, acceptance of anti-hypertensive drugs and the effectiveness of treatment in the population of the Russian Federation. Rus Jour Cardiol. 2006;4:45–50. In Russian].

3. Сыркин А. Л., Медведев В. Э., Копылов Ф. Ю., Висуров С. А. Влияние патохарактерологических расстройств на течение гипертонической болезни. Врач. 2007;4: 10–12. [Syrkin AL, Medvedev V. E., Kopylov FYu, Visurov SA. The impact on the character disorders for hypertension. Vrach. 2007;4: 10–12. In Russian].

4. Быстрова М. М., Бритов А. Н. Артериальная гипертония у женщин в постменопаузе. Кардиология. 1999;5:72–80. [Bystrova MM, Britov AN. Arterial hypertension in postmenopausal women. Kardiologiia. 1999;5:72–80. In Russian].

5. Маслова Н. П., Баранова Е. И. Гипертоническая болезнь у женщин. СПб: издательство СПбГМУ; 2000. [Maslova NP, Baranova EI. Hypertensive heart disease in women. St Petersburg: Publishing house SPbGMU; 2000. In Russian].

6. Langenickel T, Buttgereit J, Pagel I, Dietz R, Willenbrock R, Bader M. Characterization of an animal model of menopausal hypertension in SHR. Hypertension. 2003;43(2):460–463.

7. Grippo AJ, Johnson AK. Stress, depression, and cardiovascular dysregulation: A review of neurobiological mechanisms and the integration of research from preclinical disease models. Stress. 2009;12(1):1–21.

8. Janszky I, Ahnve S, Lundberg I, Hemmingsson T. Earlyonset depression, anxiety, and risk of subsequent coronary heart disease 37‑year follow-up of 49,321 young Swedish men. Am Coll Cardiol. 2010;56(1):31–37.

9. Atlantis E, Lange K, Goldney RD, Martin S, Haren MT, Taylor A et al. Specific medical conditions associated with clinically significant depressive symptoms in men. Soc Psychiatr Epidemiol. 2011;46(12):1303–1312.

10. Hildrum B, Romild U, Holmen J. Anxiety and depression lowers blood pressure: 22‑year follow-up of the population based HUNT study, Norway. BMC Public Health. 2011;11: 601.

11. Licht CM, de Geus EJ, Seldenrijk A, van Hout HP, Zitman FG, van Dyck R et al. Depression is associated with decreased blood pressure, but antidepressant use increases the risk for hypertension. Hypertension. 2009;53(4):631–638. doi: 10.1161/HYPERTENSIONAHA.108.126698

12. Акжигитов Р. Г. Современные тенденции в понимании и лечении тревожных расстройств. Росс. мед. журнал. 2002;1:43–45. [Akzhigitov RG. Current trends in the understanding and treatment of anxiety disorders. Rus Med Jour. 2002;1:43–45. In Russian].

13. Колюцкая Е. В. Тревожные расстройства: диагностика и терапия. Здоровье Украины. 2006;3:17. [Koljuckaja EV. Anxiety disorders: diagnosis and treatment. Health of Ukraine. 2006;3:17. In Russian].

14. Вейн А. М. (ред.). Вегетативные расстройства: Клиника, лечение, диагностика. М.: Медицинское информационное агентство; 2000. 725 с. [Veyn AM (ed.). Autonomic dysfunction: clinical features, treatment, diagnosis. M.: Medical News Agency; 2000. 725 p. In Russian].

15. WHO MONICA Project prepared by Kuulasmaa K. et al. Baseline population survey data book. MONICA Memo 178 A. Helsinki; 1990.

16. WHO Proposal for the Multinational Monitoring of Trends in cardiovascular disease. Geneva; 1985.

17. World Health Organization. MONICA Psychosocial Optional Study. Suggested Measurement Instruments. Copenhagen: WHO Regional Office for Europe; 1988.

18. Tunstall-Pedoe H, The World Health organization MONICA project (monitoring trends and determinants in cardiovascular disease): A major international collaboration. J Clin Epidemiol. 1988; 105–114.

19. Spielberger CD. Anxiety as an emotional state/In: C. D Spielberger (Ed.), Anxiety: Current trends in theory and research. New York: Academic Press. 1972;1:24–49.

20. SPSS: искусство обработки информации. Анализ статистических данных и восстановление скрытых закономерностей: Пер. с нем. Ахим Бююль, Петер Цёфель. СПб.: ООО «DiaSoftЮП»; 2002. 608 c. [SPSS: art information processing. Analysis of statistical data and restore hidden patterns: translated from German. Ahim Byuyul’, Peter Cjofel’. St Petersburg: OOO «DiaSoftJuP»; 2002. 608 p. In Russian].

21. Glants С. Biomedical statistics. Transl. from Eng. С. Glants. Мoscow: Practika; 1998. 459c.

22. Cox DR. Regression models and life tables. J Royal Statist Soc Ser B. 1972;34:187–220.

23. Гафаров В. В., Пак В. А., Гагулин И. В., Гафарова А. В. Эпидемиология и профилактика хронических неинфекционных заболеваний в течение 2 десятилетий и в период социально-экономического кризиса в России. Новосибирск; 2000. 284 с. [Gafarov VV, Pak VA, Gagulin IV, Gafarova AV. Epidemiology and prevention of chronic non-infectious diseases over 2 decades in period of social-economic crisis in Russia. Novosibirsk; 2000. 284 p. In Russian].

24. Гафаров В. В., Громова Е. А., Кабанов Ю. Н., Гагулин И. В. Личность и ее взаимодействие с социальной средой: непроторенная дорога. Новосибирск:Изд-во СО РАН:2008.280 с. [Gafarov VV, Gromova EA, Kabanov JuN, Gagulin IV. Personality and its interaction with the social environment: unbeaten road. Novosibirsk: SB RAMS; 2008. 280 p. In Russian].

25. Гафаров В. В., Пак В. А., Гагулин И. В., Гагулин И. В. Психология здоровья населения в России. Новосибирск; 2002. 360 с. [Gafarov VV, Pak VA, Gagulin IV, Gagulin IV. sychology of health in Russia. Novosibirsk; 2002. 360 p. In Russian].

26. Гафаров В. В., Панов Д. О., Громова Е. А., Гагулин И. В., Гафарова А. В. Влияние личностной тревожности на риск развития артериальной гипертензии в открытой популяции среди женщин 25–64 лет в условиях мегаполиса Западной Сибири (эпидемиологическое исследование на основе программы ВОЗ «MONICA-психосоциальная»). Мир науки, культуры, образования. 2014;4(47):357–359. [Gafarov VV, Panov DO, Gromova EA, Gagulin IV, Gafarova AV. Influence of personal anxiety on risk of an arterial hypertension in female population 26–64 years in Megapolis of Western Siberia (epidemiological study based on WHO program «MONICA-psychosocial»). World Sci Cult Edu. 2014;4(47):357–359. In Russian].

27. Gafarov V, Panov D, Gromova E, Gagulin I, Gafarova A. Trait anxiety, awareness, health attitudes and 16‑year hazard ratio of acute cardiovascular disease in open female population in Russia. Int J Med Med Sci. 2014;4(1):30–34.

28. Гафаров В. В., Панов Д. О., Громова Е. А., Гагулин И. В. Стресс на работе и его влияние на 16‑летний риск развития инфаркта миокарда, инсульта в открытой попу-ляции среди женщин 25–64 лет в России/Сибири (программа ВОЗ «MONICA- психосоциальная»). Терапевтический архив. 2015;87(3):71–77. [Gafarov VV, Panov DO, Gromova EA, Gagulin IV. Job stress and its influences on 16‑year risk of myocardial infarction, stroke in female population 25–64 years in Russia/Siberia (WHO program «MONICA-psychosocial»). Ter Arch. 2015;87(3):71–77. In Russian].

29. Milczarek M, Schneider E, González E. Report to European Agency for Safety and Health at Work: OSH in figures: stress at work — facts and figures. — Luxembourg: Office for Official Publications of the European Communities; 2009.

30. Daniels K. Perceived risk from occupational stress: a survey of 15 European countries. Occup Environ Med. 2004;61 (5):467–470.

31. European Foundation for the Improvement of Living and Working Conditions, Fourth European Workniting Conditions Survey. Luxembourg: Office for Official Publications of the European Commuies; 2006.

32. Wiinberg N, Hoegholm A, Christensen HR. 24‑h ambulatory blood pressure in 352 normal Danish subjects, related to age and gender. Am J Hypertension. 1995;8(10 Pt. 1):978–986.

33. Jansen NW, Kant IJ, van Amelsvoort LG, Kristensen TS, Swaen GM, Nijhuis FJ. Work-family conflict as a risk factor for sickness absence. Occup Environ Med. 2006;63(7):488–94.

34. Heslop P, Smith GD, Metcalfe C. Change in job satisfaction, and its association with self-reported stress, cardiovascular risk factors and mortality. Soc Sci Med. 2002;54(10):1589–99.

35. Holmgren K, Dahlin Ivanoff S. Women on sickness absence — views of possibilities and obstacles for returning to work. A focus group study. Disabil Rehabil. 2004;26(4):213–22.

36. Statistics Sweden: women and men in Sweden 2006. Stockholm: Official Statistics of Sweden; 2006.

37. Спилбергер Ч. Д. Концептуальные и методологические проблемы исследования тревоги. М.: Физкультура и спорт; 1983. [Spielberger CD. Conceptual and methodological problems in the study of anxiety. Moscow: Physical Culture and Sport; 1983. In Russian].

38. Casiglia E, Giordano N, Tikhonoff V, Boschetti G, Mazza A, Caffi S et al. Is menopause an independent cardiovascular risk factor? Evidence from population-based studies. J Hyperten. 2002;20(2):17–22.

39. Булгакова О. С., Степанова Н. В. Ситуативная и личностная тревожность разведенных мужчин. Международный журнал прикладных и фундаментальных исследований. 2014;10 (1):78–81. [Bulgakova OS, Stepanova NV. Situational and personal anxiety in divorced men. International Journal of Applied and Fundamental Research. 2014;10(1):78–81. In Russian].