**1. Introduction**

The widespread and widely discussed opinion in the mass media that the number of people with anxiety, depression and other affective states is increasing year to year implies a relative increase in these disorders over the past decades. Nevertheless, the study of literary sources has provided multifaceted estimates of the prevalence of psychosocial factors (PSF). Due to the different recording methods in epidemiological studies, the heterogeneity of the data is too high to make a proper comparison. According to the available epidemiological findings, one-third of the population of the United States and European countries is susceptible to anxiety disorders [1]. At the same time, the prevalence of psychosocial factors depending on sex is also different. Negative psychological characteristics (e.g., anxiety and depression) are twice as common in women and often have a more severe form and an earlier onset [2].

The impact of PSF on health is unequal in terms of gender. For example, depressive disorders are on the list of the leading widespread diseases in the world among women, but not men, according to Global Burden Diseases (2002) [3]. And this may be an echo of other common negative psychosocial factors, such as high anxiety, vital exhaustion, and stress in the family and workplace. A number of these states are inextricably linked to the XX or XY genotype or are due to sex differences in functioning (i.e., susceptibility to diseases). For other psychological factors, there is a clear link to work and social environment, which differs for both sexes [4, 5].

Cardiovascular effects of stress and other psychological factors may also differ in women and men [6]. Large-scale studies show that particular psychosocial characteristics, such as stress or depression, are associated with cardiovascular health to the same degree in men and women, while others, i.e., vital exhaustion, anxiety signs and low life satisfaction, are associated with heart disease rates in women but not in men.

Analysis of recent studies and meta-analyses [7] indicates that social gradient, as a mediator, as well as the sex differences, boost the effect of psychosocial characteristics on cardiovascular health.

Different levels of PSF are not always adverse, but can also serve as protective factors concerning physical and mental health. Thus, a favourable profile of social contacts with relatives or friends is associated with favourable indicators of mental health and serves as a barrier to depression and perceived stress. In addition, the social support received from friends is positively correlated with the lifestyle, in particular, with intensive physical activities [8]. The accumulation of data on the influence of psychosocial factors on the risk of cardiovascular events is a prerequisite for the creation of authoritative working groups and the development of international regulations and recommendations [9]. Yet the question of the impact of gender differences remains unresolved.

In Russia, such studies are rare, but the differences in the studied population and the tools used do not allow us to give comparative estimates in the dynamics of the prevalence of PSF. Moreover, there are no available cohort studies at all.

Our study identified gender differences in the prevalence and dynamics of affective states over a long period, i.e., 23 years, and determined their impact on the risk of developing CVD (such as arterial hypertension, myocardial infarction, stroke) among the population aged 25–64.
