Psychosocial risk factors of cardiovascular diseases: control strategies and methods

Psychosocial (PS) risk factors (RFs), including acute and chronic stress (at work and in family life), low social support (social isolation), hostility, type D personality, and anxiety and depressive symptoms, are recognized as independent predictors of development, progression, and adverse outcomes of cardiovascular diseases (CVD) and their complications. Nevertheless, the control and implementation of systematic approaches for identification and correction of these factors remain fragmented. This article discusses contemporary strategies for the management and correction of PS RFs in patients with CVD, including behavioral counseling, cognitive behavioral therapy, physical training, cardiac rehabilitation programs, psychopharmacotherapy, and meditation and relaxation-based practices. Particular attention is paid to the principles of rational use of antidepressants and anxiolytics in patients with CVD, taking into account efficacy, safety, and the risk of drug–drug interactions. The need for an interdisciplinary model of care involving cardiologists, general practitioners, psychologists, psychotherapists, psychiatrists, and specialists in physical and rehabilitation medicine is emphasized. The use of digital technologies, telerehabilitation, mobile applications, wearable devices, and artificial intelligence algorithms for screening, monitoring, and personalization of interventions is considered a promising direction. Timely identification and correction of PS RFs should be considered as an important component of secondary prevention, cardiac rehabilitation, and reduction of residual cardiovascular risk.