Psychosocial distress as a risk factor of ischemic heart disease mortality.

BACKGROUND Ischemic heart disease (IHD) is the leading cause of morbidity and mortality in the industrialized world. Recent research evidence suggests that psychosocial distress has been implicated as both a precursor to IHD and a significant risk factor for death in those with established IHD. According to WHO, psychosocial distress will be the most harmful risk factor for the development of IHD in the near future. Some experts have underlined the importance of the psychosocial distress of economic and political reforms as the main reason for the IHD mortality crisis in Russia in the 1990s. The aim of the present study was to estimate the effect of psychosocial distress on IHD mortality rate in Russia. SUBJECTS AND METHODS Trends in age-adjusted, sex-specific suicide (as an integral indicator for psychosocial distress) and IHD mortality rate in Russia from 1965 to 2005 were analyzed employing a distributed lags analysis in order to assess the bivariate relationship between the two time series. RESULTS Time series analysis indicates the presence of a statistically significant association between the two time series for males at lags 0 and females at lags 0 and 1. CONCLUSIONS These findings suggest that the Russian IHD mortality crisis is most likely to have been precipitated by the psychosocial distress imposed by rapid societal transformation. The experience of Russia should serve as an example of how societal-level change can influence the health of a population.