Social-distress determinants of circulatory system diseases: global trends and regional strategies (2021–2025)

Relevance. Circulatory system diseases remain the leading cause of death worldwide. Current research points to the need to go beyond traditional biological risk factors and account for socially distress determinants – social conditions that cause chronic stress (economic inequality, working conditions, social exclusion) which have a significant impact on cardiovascular health.

The purpose of the study: conduct a comprehensive analysis of global trends and regional approaches to the study and management of social-distress determinants for circulatory system diseases prevention in 2021–2025.

Materials and methods. A systematic analysis of scientific literature and official documents for 2021–2025 has been carried out. Searches were conducted in PubMed, MEDLINE, Google Scholar, eLIBRARY.ru, and resources from the WHO, the European Society of Cardiologists, and the American Association of Cardiology. The final analysis includes sources including original studies, systematic reviews, clinical guidelines and analytical reports. Comparative and content-analysis methods are applied.

Results. The increasing influence of macro crises (COVID‑19 pandemic, climate change) as a super-determinant has been identified, worsening social gradient in BSC outcomes and causing a global rise in psychological distress. Established a trend for integrating mental health into cardiac care (recommendations of the European Society of Cardiologists 2021/2023). The focus of prevention is shifted to creating a health-saving environment through fiscal and urban policies (“health in all policies”). Comparative analysis of regional strategies for managing social-distress determinants in Europe (social purpose), North America (standardized screening), Asia (air pollution control, corporate programs) and low-income countries (community projects, mhGAP programme). Methodological aspects of the assessment of social-distress determinants are highlighted, including questions of validation of complex surveys through verification of convergent validity with international scales (WHOQOL-BREF, PSS, SCORE2).

Conclusion. Period 2021–2025 was marked by a shift from accumulating knowledge about the harm of social-distress determinants to actively implementing practical strategies for their nivelling. The prospects are linked to the personalization of prevention and intersectoral cooperation. Key challenges remain industrial lobby resistance, the difficulty of assessing long-term efficiency, and the risks of digital inequality. Taking into account social context is a prerequisite for reducing the global burden of circulatory disease.

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