Metabolic and anxiety-depressive disorders in patients with polymorbid cardiovascular disease

The peculiarities of the influence of the metabolic disorders and depressive spectrum disorders in the development of polymorbid pathology are investigated. 160 male patients were examined, divided into three groups. The first group included 56 young men, 39–40.2 years old, body mass index 34.2–35 kg/m², suffering from the polymorbid cardiovascular pathology, in which the presence of coronary heart disease, angina pectoris of the functional class I–II, arterial hypertension 2–3 degrees, obesity 1–2 degrees, depressive spectrum disorders was considered. The second group included 56 middle-aged men, 47.5–48.3 years old, body mass index 36.2–36.9 kg/m² with a similar combination of diseases of the first group. The third (control group) included 48 young men, 39.6–40.9 years old, body mass index 24.1–24.9 kg/m², suffering from the polymorbid cardiovascular pathology without the metabolic syndrome and obesity. The anthropometric status, glucose, insulin, total cholesterol, triglycerides, and low-density lipoproteins were assessed. Instrumental diagnostics of the coronary heart disease and hypertension was carried out, anxiety and depressive disorders were established based on the results of a questionnaire and a consultation with a psychiatrist. It was found that in a group of young and middle-aged patients suffering from the polymorbid cardiovascular pathology, in combination with a metabolic syndrome and depressive spectrum disorders, psychopathological disorders (borderline anxiety-depressive state) are associated with the metabolic disorders, high prevalence of pain-free form of myocardial ischemia and unfavorable variants of two-phase blood pressure rhythm during the day, according to the type of insufficient degree of reduction of nocturnal blood pressure — «non-dippers» and a steady increase in the night blood pressure — «night-peakers», which determines a high risk of cardiovascular complications.