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A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention.
Psychosom Med. 2008 Jul; 70(6):668-76.PM

Abstract

OBJECTIVE

To examine prospectively early-age heart disease (HD) among a national random sample of 4328 male Vietnam veterans, who did not have HD at baseline in 1985. Studies have suggested that posttraumatic stress disorder (PTSD) may result in cardiovascular disease. However, many past studies had important methodological limitations to their designs.

METHOD

Using Cox regressions, we assessed PTSD, age, race, intelligence, family history, obesity, smoking, alcohol abuse, antisocial personality, and depression in predicting HD mortality at follow-up in December 31, 2000. The men were <65 years old at follow-up.

RESULTS

Using two PTSD measures, a Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition (DSM-III) measure (D-PTSD) and one developed by Keane (K-PTSD), we found that among Vietnam theater and era veterans combined (era veterans had no Vietnam service), having PTSD was associated with HD mortality for D-PTSD (hazard ratio (HR) = 2.25, p = .045) and approached significance for K-PTSD (HR = 2.16, p = .066). However, having higher PTSD symptoms on either scale was associated with mortality, with a 5-point increase associated with approximately 20% increase in mortality risk (all p < .05). Controlling for lifetime depression only slightly altered the results. The effects for theater veterans alone were stronger (D-PTSD: HR = 2.58, p = .025; K-PTSD: HR = 2.73, p = .022). Among theater veterans, controlling for lifetime depression or combat exposure made little difference.

CONCLUSION

PTSD was prospectively associated with HD mortality among veterans free of HD at baseline. This study suggests that early-age HD may be an outcome after military service among PTSD-positive veterans.

Authors+Show Affiliations

Center for Health Research, Geisinger Clinic, 100 N. Academy Avenue, Danville, PA 17822, USA. jaboscarino@geisinger.edu

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18596248

Citation

Boscarino, Joseph A.. "A Prospective Study of PTSD and Early-age Heart Disease Mortality Among Vietnam Veterans: Implications for Surveillance and Prevention." Psychosomatic Medicine, vol. 70, no. 6, 2008, pp. 668-76.
Boscarino JA. A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention. Psychosom Med. 2008;70(6):668-76.
Boscarino, J. A. (2008). A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention. Psychosomatic Medicine, 70(6), 668-76. https://doi.org/10.1097/PSY.0b013e31817bccaf
Boscarino JA. A Prospective Study of PTSD and Early-age Heart Disease Mortality Among Vietnam Veterans: Implications for Surveillance and Prevention. Psychosom Med. 2008;70(6):668-76. PubMed PMID: 18596248.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention. A1 - Boscarino,Joseph A, Y1 - 2008/07/02/ PY - 2008/7/4/pubmed PY - 2008/9/23/medline PY - 2008/7/4/entrez SP - 668 EP - 76 JF - Psychosomatic medicine JO - Psychosom Med VL - 70 IS - 6 N2 - OBJECTIVE: To examine prospectively early-age heart disease (HD) among a national random sample of 4328 male Vietnam veterans, who did not have HD at baseline in 1985. Studies have suggested that posttraumatic stress disorder (PTSD) may result in cardiovascular disease. However, many past studies had important methodological limitations to their designs. METHOD: Using Cox regressions, we assessed PTSD, age, race, intelligence, family history, obesity, smoking, alcohol abuse, antisocial personality, and depression in predicting HD mortality at follow-up in December 31, 2000. The men were <65 years old at follow-up. RESULTS: Using two PTSD measures, a Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition (DSM-III) measure (D-PTSD) and one developed by Keane (K-PTSD), we found that among Vietnam theater and era veterans combined (era veterans had no Vietnam service), having PTSD was associated with HD mortality for D-PTSD (hazard ratio (HR) = 2.25, p = .045) and approached significance for K-PTSD (HR = 2.16, p = .066). However, having higher PTSD symptoms on either scale was associated with mortality, with a 5-point increase associated with approximately 20% increase in mortality risk (all p < .05). Controlling for lifetime depression only slightly altered the results. The effects for theater veterans alone were stronger (D-PTSD: HR = 2.58, p = .025; K-PTSD: HR = 2.73, p = .022). Among theater veterans, controlling for lifetime depression or combat exposure made little difference. CONCLUSION: PTSD was prospectively associated with HD mortality among veterans free of HD at baseline. This study suggests that early-age HD may be an outcome after military service among PTSD-positive veterans. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/18596248/A_prospective_study_of_PTSD_and_early_age_heart_disease_mortality_among_Vietnam_veterans:_implications_for_surveillance_and_prevention_ L2 - https://doi.org/10.1097/PSY.0b013e31817bccaf DB - PRIME DP - Unbound Medicine ER -