title: [Depressive symptoms worsen cardiovascular prognosis and shorten length of life in patients with arterial hypertension and ischemic heart disease].
abstract: The KOORDINATA study (clinical epidemiological program of investigation of depression in cardiological practice in patients with arterial hypertension and ischemic heart disease) was a prospective 3 year long multicenter study of effects of depressive and anxiety states on the course and prognosis of ischemic heart disease (IHD) and arterial hypertension (AH).
  
  
  METHODS
  Patients (n=5038, age more or equal 55 years) with verified IHD and/or AH from 37 cities were included into the study. Symptoms of anxiety and depression were assessed by the HADS scale (Hospital Anxiety And Depression Scale) validated in Russia.
  
  
  RESULTS
  Clinically significant symptoms of anxiety ( more or equal 11 HADS) were present in 33 and 38%, of depression - in 30 and 38% of patients with IHD and AH, respectively. Presence of clinically manifested depression at initial examination increased 1.59 times combined risk of nonfatal and fatal cases (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.30-1.96, p=0.0001), 1.64 times - risk of cardiovascular death (OR 1.64, 95% CI 1.20-2.24, p=0.0021), and 1.82 times - risk of death from all causes (OR 1.82, 95% CI 1.41-2.34, p=0.0001). It is known that for somatic patients crossover of anxiety and depression symptoms is typical (simultaneous presence of some symptoms of anxiety and depression). Total HADS score equal to 11 or more increased risk of all cause death (OR 1.41, 95% CI 1.08-1.84, p=0.0111), as well as fatal and nonfatal events (OR 1.33, 95% CI 1.08-1.65, p=0.0089).
  
  
  CONCLUSIONS
  Taking into consideration negative effect of depressive symptoms on prognosis it is recommended to screen patients with IHD in the first place those who have had myocardial infarction and brain stroke with the aim of detection of depression and anxiety depressive symptoms and subsequent their adequate correction.
authors.forename: R G
authors.initials: RG
authors.lastname: Oganov
authors.forename: G V
authors.initials: GV
authors.lastname: Pogosova
authors.forename: I E
authors.initials: IE
authors.lastname: Koltunov
authors.forename: L V
authors.initials: LV
authors.lastname: Romasenko
authors.forename: A D
authors.initials: AD
authors.lastname: Deev
authors.forename: Iu M
authors.initials: IuM
authors.lastname: Iufereva
mesh_terms: D001794:Blood Pressure; D003863:Depression / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends