Is Combat Deployment and PTSD Associated With CHD?

For many military servicemen and women returning from active duty, the development of post-traumatic stress disorder (PTSD) puts a remarkable strain on one's mental health. Looking beyond the neural biology of PSTD, a new cardio-based investigation has sought to better understand the impact of combat trauma on the heart, specifically on coronary heart disease (CHD) in young adults.

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Researchers have determined that combat deployments are associated with new-onset of CHD among young U.S. service members and veterans and that experiences of intense stress may increase the risk for CHD over a relatively short period, according to a study published March 11 in Circulation.

Conducting a prospective, cohort study, lead author Nancy Crum-Cianflone, MD, MPH, and colleagues utilized data of current and former U.S. military personnel from all service branches participating in the Millennium Cohort Study during 2001-2008. Of the 60,025 participants a total of 627 (1.0 percent) self-reported CHD over a mean of 5.6 years. While mean age of the participants was 34.4 years, the mean age of those with newly reported CHD was 43.1 years. At their baseline assessment, service members with newly reported CHD were proportionally more likely to be male, married, obese, a smoker, a heavy drinker, inactive in regards to physical activity and strength training, in the Reserves/National Guard or Army, and have hypertension, depression, or diabetes.

Among the studied population, 900 individuals had been deployed and experienced combat before their baseline assessment, while 6,446 experienced combat between their baseline assessment and their first follow-up (or report of CHD if indicated), and 7,024 between the first and second follow-up assessments (or report of CHD if indicated). A total of 1,193 participants screened positive for PTSD at the baseline assessment, 1,304 at the first follow-up, and 1,826 at the second follow-up. The mean time between the baseline assessment and the first follow-up was 2.7 years, while the mean time between the second follow-up was 2.9 years. Without adjusting for depression and anxiety, screening positive for PTSD was significantly associated with newly self-reported CHD in the study's multivariable model, as well as in its adjusted model for age, sex, and race.

Highlighting the potential impact of acutely stressful experiences—specifically for those who have endured combat situations—the authors conclude that the findings of their study strongly suggest that young, military personnel have a heightened risk for the development of CHD over a relatively short period of time.

Clinical Topics: Prevention, Hypertension

Keywords: Stress Disorders, Post-Traumatic, Depressive Disorder, Follow-Up Studies, Veterans, Coronary Disease, Military Personnel, Hypertension, Mental Health, Diabetes Mellitus

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