Терапия №5 (Международный выпуск) / 2026
Anxiety and depressive symptomatology and their associations with cardiometabolic risk factors in the youth population: a cross-sectional study
1) South Ural State Medical University, Chelyabinsk, Russian Federation;
2) Yaroslav-the-Wise Novgorod State University, Veliky Novgorod, Russian Federation
Background. Psychosocial factors, including anxiety and depressive symptoms, significantly influence the risk of developing cardiometabolic diseases and treatment adherence. The early diagnosis of these conditions in young individuals is a promising direction for primary prevention programs.
Objective: To evaluate the association among anxiety, depression, and behavioral cardiometabolic risk factors among university students.
Materials and methods. A cross-sectional study (survey) was conducted on 3296 students (22.7% male, 77.3% female; median age 21.0 years) from 19 universities across 16 Russian cities. The HADS scale was used to assess psychosocial status, while the CINDI (smoking, nutrition and alcohol) and IPAQ (physical activity) questionnaires were used to evaluate lifestyle factors.
Results. The prevalence rates of anxiety and depression were 48.3% and 32.6%, respectively. Anxiety was significantly more frequent in women (52.4% vs. 34.6% in men; p < 0.001). Multivariate analysis showed that the risk of anxiety was associated with active smoking (odds ratio [OR] 1.53; 95% confidence interval [CI]: 1.24–1.88), alcohol consumption (OR 1.66), low physical activity (OR 1.22), and suboptimal nutrition (OR 1.39). The risk of depression was associated with low physical activity (OR 1.47) and suboptimal nutrition (OR 1.44).
Conclusion. A high prevalence of anxiety and depression was identified in the youth population, showing independent associations with modifiable cardiometabolic risk factors.
For citation: Gavrilova ES, Chulkov VS. Anxiety and depressive symptomatology and their associations with cardiometabolic risk factors in the youth population: A cross-sectional study. Therapy (Moscow). 2026;12(5S):17–21.
https://doi.org/10.18565/therapy.2026.5-s5.17-21
INTRODUCTION
Psychosocial factors can substantially influence the clinical course of cardiometabolic diseases by increasing the risk of complications and mortality, reducing treatment adherence, and impairing quality of life. Anxiety and depressive symptoms occupy a distinct position among cardiometabolic risk factors because they cannot be classified as exclusively behavioral or biological. According to the INTERHEART study, depression and psychosocial stress were identified as independent risk factors for coronary artery disease (CAD) and hypertension. Psychosocial factors are also relevant to hypertension, CAD, and diabetes mellitus. Dietary patterns may be associated with general anxiety, whereas low physical activity has been associated with depressive symptoms.
According to a meta-analysis of 20 prospective studies involving approximately 250,000 initially healthy individuals, anxiety symptoms were associated with an increased risk of CAD and CAD-related mortality. The independent prognostic value of anxiety in patients with stable CAD has also been demonstrated.
Baseline depressive symptoms have been associated with a 1.6- to 2.2-fold higher subsequent risk of CAD and adverse cardiovascular outcomes. Greater depression severity has also been associated with earlier and more severe cardiovascular complications. The KOMPAS and KOORDINATA studies showed that approximately half of patients with hypertension and CAD had anxiety and depressive symptoms, with clinically significant symptoms reported in approximately one-third. In the KOMETA study, clinically significant anxiety and depressive symptoms were reported in 25.5% and 16.0% of respondents, respectively.
Research on anxiety and depressive symptoms in young adults is increasingly important because cardiometabolic risk factors and predictors are already prevalent in this population, even when clinically manifest disease is absent. Early identification of anxiety and depressive symptoms and their associations with risk factors may help inform cardiometabolic disease prevention programs.
The aim of this study was to evaluate the associations of anxiety and depressive symptoms with behavioral cardiometabolic risk factors among university students.
METHODS
A survey was conducted among 3,296 students from 19 higher education institutions in 16 cities (Blagoveshchensk, Vladivostok, Volgograd, Kemerovo, Moscow, Nalchik, Novosibirsk, Pyatigorsk, Rostov-on-Don, Samara, Surgut, Ryazan, Tomsk, Ulyanovsk, Chelyabinsk, and Yaroslavl). The sample included 22.7% men and 77.3% women; the median age was 21.0 years (Q1–Q3: 19.0–22.0).
Data collected included sex, age, grade point average (GPA), and year of study. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). The scale comprises 14 items divided equally between the anxiety (HADS-A) and depression (HADS-D) subscales. Scores of 0–7 were consider...
