- For veterans, the association of posttraumatic stress disorder (PTSD) and incident cardiovascular disease (CVD) appears to be mediated by physical and psychiatric disorders and smoking.
- Authors: “Recognizing that PTSD does not preordain CVD may empower patients to seek care to prevent and/or manage CVD risk factors.”
Why this matters
- PTSD is a risk factor for CVD.
- Correlates in patients with PTSD such as abnormal cortisol regulation, increased inflammation, heavy smoking, and depression could explain the association.
- CVD rate among patients with vs without PTSD: 46.7 vs 33.3 per 1000 person-years (P<.0001>
- After extensive adjustment for physical, psychiatric, and behavioral conditions:
- Association between PTSD and CVD disappeared: HR, 0.96 (95% CI, 0.81-1.15).
- PTSD was also not associated with all-cause mortality: HR, 0.83 (95% CI, 0.59-1.28).
- Analysis of electronic health records at 5 US Veterans Health Affairs hospitals, 2008-2012; observation until 2015.
- Participants were aged 30-70 years (n=11,856; n=5940 with PTSD).
- Authors followed patients with and without PTSD, adjusting for numerous covariates.
- Outcome: incident CVD.
- Funding: NIH.
- Maximum follow-up was 8 years, but CVD could have developed later.
- Most patients were middle-aged men.