Preview

Meditsinskiy sovet = Medical Council

Advanced search

Addressing the issue of anxiolytics prescription in cardiovascular diseases: A perspective from the neurologist and cardiologist

Abstract

The role of anxiety disorders in the onset and progression of cardiovascular diseases, the relationship between them, and effective treatment strategies for comorbid patients have been discussed with our experts:

Olga D. Ostroumova, Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Chair of the RSC Working Group on Cardioneurology, Member of the Presidium of the Moscow Society of Cardiology, Chairman of the Moscow Regional Branch of the Russian Scientific Medical Society of Internal Medicine (RNMOT).

Vladimir A. Parfenov, Dr. Sci. (Med.), Professor, Head of the Department of Nervous Diseases, Institute of Clinical Medicine, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University).

About the Authors

O. D. Ostroumova
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation
Russian Federation

Olga D. Ostroumova - Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Chair of the RSC Working Group on Cardioneurology, Member of the Presidium of the Moscow Society of Cardiology, Chairman of the Moscow Regional Branch of the Russian Scientific Medical Society of Internal Medicine (RNMOT).



V. A. Parfenov
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Vladimir A. Parfenov - Dr. Sci. (Med.), Professor, Head of the Department of Nervous Diseases, Institute of Clinical Medicine, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University).



References

1. Vaccarino V, Prescott E, Shah AJ, Bremner JD, Raggi P, Dobiliene O et al. Mental health disorders and their impact on cardiovascular health disparities. Lancet Reg Health Eur. 2025;56:101373. https://doi.org/10.1016/j.lanepe.2025.101373.

2. Michal M, Beutel M. Mental disorders and cardiovascular disease: what should we be looking out for? Heart. 2021;107(21):1756–1761. https://doi.org/10.1136/heartjnl-2019-316379.

3. Thurston RC, Rewak M, Kubzansky LD. An anxious heart: anxiety and the onset of cardiovascular diseases. Prog Cardiovasc Dis. 2013;55(6):524–537. https://doi.org/10.1016/j.pcad.2013.03.007.

4. Cohen BE, Edmondson D, Kronish IM. State of the Art Review: Depression, Stress, Anxiety, and Cardiovascular Disease. Am J Hypertens. 2015;28(11):1295–1302. https://doi.org/10.1093/ajh/hpv047.

5. Tully PJ, Harrison NJ, Cheung P, Cosh S. Anxiety and Cardiovascular Disease Risk: a Review. Curr Cardiol Rep. 2016;18(12):120. https://doi.org/10.1007/s11886-016-0800-3.

6. Todaro JF, Shen BJ, Raffa SD, Tilkemeier PL, Niaura R. Prevalence of anxiety disorders in men and women with established coronary heart disease. J Cardiopulm Rehabil Prev. 2007;27(2):86–91. https://doi.org/10.1097/01.HCR.0000265036.24157.e7.

7. Roest AM, Martens EJ, de Jonge P, Denollet J. Anxiety and risk of incident coronary heart disease: a meta-analysis. J Am Coll Cardiol. 2010;56(1):38–46. https://doi.org/10.1016/j.jacc.2010.03.034.

8. Haftgoli N, Favrat B, Verdon F, Vaucher P, Bischoff T, Burnand B, Herzig L. Patients presenting with somatic complaints in general practice: depression, anxiety and somatoform disorders are frequent and associated with psychosocial stressors. BMC Fam Pract. 2010;11:67. https://doi.org/10.1186/1471-2296-11-67.

9. Pogosova N, Boytsov S, De Bacquer D, Sokolova O, Ausheva A, Kursakov A, Saner H. Factors Associated with Anxiety and Depressive Symptoms in 2775 Patients with Arterial Hypertension and Coronary Heart Disease: Results from the COMETA Multicenter Study. Glob Heart. 2021;16(1):73. https://doi.org/10.5334/gh.1017.

10. Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990–2013: The GBD 2013 Study. Neuroepidemiology. 2015;45:161–176. https://doi.org/10.1159/000441085.

11. Donnellan C, Hickey A, Hevey D, O’Neill D. Effect of mood symptoms on recovery one year after stroke. Int J Geriatr Psychiatry. 2010;25:1288–1295. https://doi.org/10.1002/gps.2482.

12. Rafsten L, Danielsson A, Sunnerhagen KS. Anxiety after stroke: A systematic review and meta-analysis. J Rehabil Med. 2018;50(9):769–778. https://doi.org/10.2340/16501977-2384.

13. Васильева АВ, Зинченко ЮП, Исаева ЕР, Караваева ТА, Мизинова ЕБ, Мосолов СН и др. Генерализованное тревожное расстройство: клинические рекомендации. 2024. Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/457_3.

14. Kawachi I, Sparrow D, Vokonas PS, Weiss ST. Symptoms of anxiety and risk of coronary heart disease. The Normative Aging Study. Circulation. 1994;90(5):2225–2229. https://doi.org/10.1161/01.CIR.90.5.2225.

15. Vaccarino V, Bremner JD. Stress and cardiovascular disease: an update. Nat Rev Cardiol. 2024;21(9):603–616. https://doi.org/10.1038/s41569-024-01024-y.

16. Zhao B, Yao Y, Gao T. The effect of psychological intervention on the quality of life and rehabilitation outcome of stroke patients with anxiety and depression: A systematic review. Medicine. 2024;103(45):e40439. https://doi.org/10.1097/MD.0000000000040439.

17. Thurston RC, Rewak M, Kubzansky LD. An anxious heart: anxiety and the onset of cardiovascular diseases. Prog Cardiovasc Dis. 2013;55(6):524–537. https://doi.org/10.1016/j.pcad.2013.03.007.

18. Shah RM, Doshi S, Shah S, Patel S, Li A, Diamond JA. Impacts of Anxiety and Depression on Clinical Hypertension in Low-Income US Adults. High Blood Press Cardiovasc Prev. 2023;30(4):337–342. https://doi.org/10.1007/s40292-023-00584-3.

19. Jonas BS, Lando JF. Negative affect as a prospective risk factor for hypertension. Psychosom Med. 2000;62(2):188–196. https://doi.org/10.1097/00006842-200003000-00006.

20. Zhou J, Fangma Y, Chen Z, Zheng Y. Post-Stroke Neuropsychiatric Complications: Types, Pathogenesis, and Therapeutic Intervention. Aging Dis. 2023;14(6):2127–2152. https://doi.org/10.14336/AD.2023.0310-2.

21. Lei XY, Chen LH, Qian LQ, Lu XD. Psychological interventions for post-stroke anxiety and depression: Current approaches and future perspectives. World J Psychiatry. 2025;15(6):103270. https://doi.org/10.5498/wjp.v15.i6.103270.

22. Isensee B, Wittchen HU, Stein MB, Höfler M, Lieb R. Smoking increases the risk of panic: findings from a prospective community study. Arch Gen Psychiatry. 2003;60(7):692–700. https://doi.org/10.1001/archpsyc.60.7.692.

23. Hoertel N, Le Strat Y, De Maricourt P, Limosin F, Dubertret C. Are subjects in treatment trials of panic disorder representative of patients in routine clinical practice? Results from a national sample. J Affect Disord. 2013;146(3):383–389. https://doi.org/10.1016/j.jad.2012.09.023.

24. Muotri RW, Bernik MA. Panic disorder and exercise avoidance. Braz J Psychiatry. 2014;36(1):68–75. https://doi.org/10.1590/1516-4446-2012-1012.

25. Ebzeeva EYu, Mironova EV, Doldo NM. Anxiety disorders in the practice of a primary care physician. Poliklinika. 2023;3(2):55–58. (In Russ.) Available at: https://www.poliklin.ru/imagearticle/2023-3-2%20Revma/Poliklinika_3(2)_Nevro_2023_page_55-59.pdf.

26. Ebzeeva EYu, Polyakova OA. Anxiety and sleep disorders. Meditsinskiy Sovet. 2022;16(11):108–113. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-11-108-113.

27. Ojagbemi A, Akinyemi J, Owolabi M, Akinyemi R, Arulogun O, Gebregziabher M et al. Predictors and prognoses of new onset post-stroke anxiety at one year in black Africans. J Stroke Cerebrovasc Dis. 2020;29:105082. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105082.

28. Wang J, Zhao D, Lin M, Huang X, Shang X. Post-stroke Anxiety Analysis via Machine Learning Methods. Front Aging Neurosci. 2021;13:657937. https://doi.org/10.3389/fnagi.2021.657937.

29. Almhdawi KA, Alazrai A, Kanaan S, Shyyab AA, Oteir AO, Mansour ZM, Jaber H. Post-stroke depression, anxiety, and stress symptoms and their associated factors: A cross-sectional study. Neuropsychol Rehabil. 2021;31:1091–1104. https://doi.org/10.1080/09602011.2020.1760893.

30. Gelenberg AJ. Psychiatric and Somatic Markers of Anxiety: Identification and Pharmacologic Treatment. Prim Care Companion J Clin Psychiatry. 2000;2(2):49–54. https://doi.org/10.4088/pcc.v02n0204.

31. Ebzeeva EYu, Ostroumova OD, Mironova EV, Doldo NM. Psychological stress and cardiovascular diseases: clinical case. Meditsinskiy Sovet. 2022;16(23):110–116. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-23-110-116.

32. Vasilyeva AV. Using the Neuroscanner mobile app in diagnosing anxiety disorders and choosing therapy. Lechaschi Vrach. 2020. (In Russ.) Available at: https://www.lvrach.ru/author/11578820.

33. Vasilyeva AV. Actual problems of diagnosis of depressive disorders. Lechaschi Vrach. 2020. (In Russ.) Available at: https://www.lvrach.ru/partners/velaxin/15437705.

34. Ivanova LA. Anxiety disorders therapy in general practice. Acta Biomedica Scientifica. 2017;2(5-2):121–124. (In Russ.) https://doi.org/10.12737/article_5a3a0e7b6a3885.64967546.

35. Nungulo VN, Gonçalves M, Henriques MA, Baixinho CL. Effectiveness of psychoeducational intervention in promoting post-stroke self-care: a systematic literature review. Front Rehabil Sci. 2025;6:1569526. https://doi.org/10.3389/fresc.2025.1569526.

36. Le HT, Honma K, Annaka H, Sun S, Nomura T. Effectiveness of Problem-Solving Therapy in Improving Patient Mental Health, Function, Quality of Life, and Mortality Post-Stroke: A Systematic Review. Behav Sci. 2024;14(6):446. https://doi.org/10.3390/bs14060446.

37. Domínguez-Borràs J, Vuilleumier P. Amygdala function in emotion, cognition, and behavior. Handb Clin Neurol. 2022;187:359–380. https://doi.org/10.1016/B978-0-12-823493-8.00015-8.

38. Wu CK, Huang YT, Lee JK, Jimmy Juang JM, Tsai CT, Lai LP et al. Anti-anxiety drugs use and cardiovascular outcomes in patients with myocardial infarction: a national wide assessment. Atherosclerosis. 2014;235(2):496–502. https://doi.org/10.1016/j.atherosclerosis.2014.05.918.

39. Horváth EJ, Horváth K, Hámori T, Fekete MI, Sólyom S, Palkovits M. Anxiolytic 2,3-benzodiazepines, their specific binding to the basal ganglia. Prog Neurobiol. 2000;60(4):309–342. https://doi.org/10.1016/s0301-0082(99)00020-9.

40. Levin OS. Anxiety disorders in clinical practice. Meditsinskiy Sovet. 2017;(10):36–40. (In Russ.) https://doi.org/10.21518/2079-701X-2017-10-36-40.

41. Wu CK, Huang YT, Lee JK, Jimmy Juang JM, Tsai CT, Lai LP et al. Anti-anxiety drugs use and cardiovascular outcomes in patients with myocardial infarction: a national wide assessment. Atherosclerosis. 2014;235(2):496–502. https://doi.org/10.1016/j.atherosclerosis.2014.05.918.

42. Abdelmonaem AA, Abdel-Aziz AM, Ibrahim YF, Abdelzaher WY, Amgad Mohammed N, Marey H et al. Cardioprotective effect of tofisopam against isoprenaline-induced myocardial infarction in rats via modulation of NLRP3IL-1βcaspase-1 pathway. Immunopharmacol Immunotoxicol. 2024;46(6):902–911. https://doi.org/10.1080/08923973.2024.2421528.

43. Hovi-Viander M, Kanto J, Scheinin H, Scheinin M. Tofisopam and midazolam: differences in clinical effects and in changes of CSF monoamine metabolites. Br J Clin Pharmacol. 1985;20(5):492–496. https://doi.org/10.1111/j.1365-2125.1985.tb05105.x.

44. Löw K, Crestani F, Keist R, Benke D, Brünig I, Benson JA et al. Molecular and neuronal substrate for the selective attenuation of anxiety. Science. 2000;290(5489):131–134. https://doi.org/10.1126/science.290.5489.131.

45. Horváth EJ, Horváth K, Hámori T, Fekete MI, Sólyom S, Palkovits M. Anxiolytic 2,3-benzodiazepines, their specific binding to the basal ganglia. Prog Neurobiol. 2000;60(4):309–342. https://doi.org/10.1016/s0301-0082(99)00020-9.

46. Kalashnikov SV, Kalashnikova EA, Kokarovtseva SN. Immunomodulating effects of tofizopam (Grandaxin) and diazepam in vitro. Mediators Inflamm. 2002;11(1):53–59. https://doi.org/10.1080/09629350210309.

47. Kovalev DV, Skibitsky VV, Kurzanov AN, Ponomareva AI. The efficacy of antihypertensive treatment combination with anxiolytics in hypertensives with anxiety disorder. Russian Journal of Cardiology. 2017;(4):99–104. (In Russ.) https://doi.org/10.15829/1560-4071-2017-4-99-104.

48. Starostina EG, Moshnyaga EN, Bobrov AE. Efficacy and safety of drug therapy for anxiety disorders in patients with diabetes mellitus. Diabetes Mellitus. 2010;13(3):52–55. (In Russ.) https://doi.org/10.14341/2072-0351-5488.

49. Сычев ДА, Остроумова ОД (ред.). Лекарственно-индуцированные заболевания. Том II. М.: Прометей; 2022. 536 c.

50. Artemov AN, Vasilenko IV, Trif YuV, Markina VA. Estimation of the effectiveness of grandaxin with the anxious disorder after stroke. Medical Scientific Bulletin of Central Chernozemye. 2011;(44):10–14. (In Russ.) Available at: https://elibrary.ru/sagsqv.


Review

For citations:


Ostroumova OD, Parfenov VA. Addressing the issue of anxiolytics prescription in cardiovascular diseases: A perspective from the neurologist and cardiologist. Meditsinskiy sovet = Medical Council. 2026;(3):8-16. (In Russ.)

Views: 165

JATS XML


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)