Interdisciplinary concept of the cardio-reproductive pathway: women's health awareness as a component of cardiovascular event prevention
Salov I.A., Malinova L.I., Malenova A.Yu., Markina M.A., Tolstov S.N.
Objective: To investigate the impact of women’s awareness of their health status on cardiovascular health parameters and long-term cardiovascular outcomes.
Materials and methods: The study was conducted in two stages. The first stage was an observational, cross-sectional study analyzing baseline data from 325 women. The second stage was a prospective cohort study with a median follow-up of 13 years, designed to assess long-term cardiovascular outcomes and adherence to medical follow-up. To assess awareness levels, an original composite Awareness Index (AI) was calculated, incorporating measures of knowledge, behavior, and medical activity. The index comprised five components: (1) knowledge of cardiovascular risk factors and their contribution to cardiovascular disease; (2) implementation of healthy lifestyle practices; (3) self-assessment of quality of life; (4) awareness of reproductive risk factors and their contribution to cardiovascular pathology; and (5) awareness of personal health status and disease-related symptoms.
Results: The study cohort consisted of employed women, predominantly of older working age, with low baseline cardiovascular risk and relatively favorable cardiometabolic profiles. Exploratory factor analysis revealed a two-factor structure reflecting health awareness and cardiometabolic status, which were largely independent. Over the 13-year follow-up period, cardiovascular events were documented in 16.1% of the participants. Awareness indicators were not associated with a statistically significant reduction in cardiovascular event risk, suggesting that awareness alone has limited prognostic value without corresponding behavioral and clinical changes.
Conclusion: These findings suggest that health awareness is an independent but insufficient factor for preventing cardiovascular events among working women. This highlights the need for comprehensive interventions across all stages of the cardio-reproductive pathway that target knowledge acquisition, behavioral modification, and improved access to medical care.
Authors' contributions: Salov I.A., Malinova L.I. – conception and design of the study; Malenova A.Yu., Markina M.A. – data collection and processing; Malinova L.I. – statistical analysis; Malinova L.I., Tolstov S.N. – drafting of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the Saratov State Medical University named after V.I. Razumovsky, Ministry of Health of Russia.
Disclosure of information on the use of AI: A freely accessible AI tool was used when working with information sources and creating a list of references. All references were checked by the authors.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Salov I.A., Malinova L.I., Malenova A.Yu., Markina M.A., Tolstov S.N. Interdisciplinary concept of the cardio-reproductive pathway: women's health awareness as a component of cardiovascular event prevention.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (3): 58-67 (in Russian)
https://dx.doi.org/10.18565/aig.2025.382
Keywords
cardio-reproductive pathway
health awareness
cardiovascular risk
prevention
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Received 23.12.2025
Accepted 12.02.2026
About the Authors
Igor A. Salov, Dr. Med. Sci., Professor, Honored Doctor of the Russian Federation, Professor at the Department of Obstetrics and Gynecology, Faculty of Medicine,Saratov State Medical University named after V.I. Razumovsky, Ministry of Health of the Russian Federation, 410012, Russia, Saratov, B. Kazachya str., 112, salov.i.a@mail.ru,
https://orcid.org/0000-0002-1926-5418
Lidia I. Malinova, Dr. Med. Sci., Associate Professor at the Department of Therapy with courses of cardiology, functional diagnostics and geriatrics, Saratov State Medical University named after V.I. Razumovsky, Ministry of Health of the Russian Federation, 410012, Russia, Saratov, B. Kazachya, 112, lidia.malinova@yandex.ru,
https://orcid.org/0000-0002-0951-9314
Anastasia Yu. Malenova, Resident at the Department of Therapy with courses of cardiology, functional diagnostics and geriatrics, Saratov State Medical University named
after V.I. Razumovsky, Ministry of Health of the Russian Federation, 410012, Russia, Saratov, B. Kazachya str., 112, anastysa2000@yandex.ru,
https://orcid.org/0009-0006-2891-8501
Maria A. Markina, Resident at the Department of Therapy with courses in cardiology, functional diagnostics and geriatrics, Saratov State Medical University
named after V.I. Razumovsky, Ministry of Health of the Russian Federation, 410012, Russia, Saratov, B. Kazachya str., 112, markina2626@gmail.com
Sergey N. Tolstov, Dr. Med. Sci., Associate Professor at the Department of Therapy with courses of cardiology, functional diagnostics and geriatrics, Saratov State Medical University named after V.I. Razumovsky, Ministry of Health of the Russian Federation, 410012, Russia, Saratov, B. Kazachya str., 112, tolstovsn@mail.ru,
https://orcid.org/0000-0002-4546-9449
Corresponding author: Sergey N. Tolstov, tolstovsn@mail.ru
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