CLINICAL VARIANTS OF SOMATOGENIC ASTHENIC SYMPTOM COMPLEX AND CARDIOVASCULAR RISK IN COMBATANTS

Abstract

Summary. The relevance of the study is determined by the imperfection of existing approaches in the assessment of cardiovascular risk (CVR), based on laboratory and instrumental assessments and does not take into account either the psychological portrait of the individual or the presence of non-psychotic mental disorders. This is what requires the improvement of the concept of activity at the primary level of care, in order to increase the effectiveness of preventive measures and improve the prognosis of patients with high CVR.

The aim of the study – to learn the frequency and nature of clinical variants of somatogenous asthenic symptom complex among combatants stratified by CVR level.

Materials and Methods. The primary information base for the study was the results of a comprehensive clinical and anamnestic examination of 450 combatants, including 400 people who had NSAIDs and who were previously stratified by the level of cardiovascular risk (CVR), determined by the method of "SCORE". The application of this technique took into account age, sex, the presence of smoking, blood pressure, etc. and provided for the possibility of extrapolating the possible risk to old age.

Results. Among 99 patients with minimal CVR, it was found that SASC occurred in (21.2±4.1) % of exami­ned: equally common were all clinical variants of SASC (their frequency ranged from (3.0±1.7) % – asthenic, up to (7.1±2.6) % –  astheno-anxiety and astheno-subdepressive). In this case, the intermediate position in terms of frequency was occupied by the dissomnic variant of SASC – (4.0±2.0) %.  Among 102 patients with mean CVR, it was found that the frequency of CVR in this group did not differ from the same group with minimal CVR and was (21.6±4.1) %, but in the structure of CVR group with mean CVR is significant (p≤0,05) more clinical variants of the asthenic type, the frequency of which was (11.8 ± 3.2)%, while other clinical variants in this group were diagnosed with the same frequency (in the range from (2.0±1.4) % – dysnomic option up to (4.9±2.1) % –  astheno-subdepressive, p> 0..05). Among 97 patients with high CVR, it was found that SASC occurred significantly (p≤0.05) less often than with minimal CVR – in (10.1±3.2) % of exami­ned, and the frequency of diagnosis of clinical variants of SASC were detected equally often (from (1.0±1.0) % – dyssomnic, to (3.0±1.7) % – astheno-anxiety and astheno-subdepressive, p> 0.05) Among 102 patients with realized CVR (patients with CVR) it was found that SASC occurred significantly (p≤0.05) more often than at high levels of CVR – in (20.6±4.0) % of subjects: the most common was asthenic form of SASC (p≤0.05), and the most rarely diagnosed – dissomnic variant of SASC – in (2.0±1.4) % of patients.

Conclusions. The study determined the frequency and nature of clinical variants of SASC in combatants with different levels of CVR and proved the presence of the highest frequency of asthenic type (p <0.05) in the group of patients with moderate CVR compared to other clinical variants. It is proved that the asthenic type of SASC is most characteristic of patients with realized CVR and patients with an average level of CVR (12.7±3.3) % and (11.8±3.2) %, respectively), while other clinical variants of SASC were detected with the same frequency among patients with different levels of CVR.