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. 2015 Apr;105(4):757-63.
doi: 10.2105/AJPH.2014.302342. Epub 2015 Feb 25.

Posttraumatic stress disorder and incident heart failure among a community-based sample of US veterans

Samit S Roy  1 , Randi E Foraker, Richard A Girton, Alyssa J Mansfield
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Free PMC article

Posttraumatic stress disorder and incident heart failure among a community-based sample of US veterans

Samit S Roy et al. Am J Public Health. 2015 Apr.
Free PMC article

Abstract

Objectives: We investigated the association between posttraumatic stress disorder (PTSD) and incident heart failure in a community-based sample of veterans.

Methods: We examined Veterans Affairs Pacific Islands Health Care System outpatient medical records for 8248 veterans between 2005 and 2012. We used multivariable Cox regression to estimate hazard ratios and 95% confidence intervals for the development of heart failure by PTSD status.

Results: Over a mean follow-up of 7.2 years, veterans with PTSD were at increased risk for developing heart failure (hazard ratio [HR] = 1.47; 95% confidence interval [CI] = 1.13, 1.92) compared with veterans without PTSD after adjustment for age, gender, diabetes, hyperlipidemia, hypertension, body mass index, combat service, and military service period. Additional predictors for heart failure included age (HR = 1.05; 95% CI = 1.03, 1.07), diabetes (HR = 2.54; 95% CI = 2.02, 3.20), hypertension (HR = 1.87; 95% CI = 1.42, 2.46), overweight (HR = 1.72; 95% CI = 1.25, 2.36), obesity (HR = 3.43; 95% CI = 2.50, 4.70), and combat service (HR = 4.99; 95% CI = 1.29, 19.38).

Conclusions: Ours is the first large-scale longitudinal study to report an association between PTSD and incident heart failure in an outpatient sample of US veterans. Prevention and treatment efforts for heart failure and its associated risk factors should be expanded among US veterans with PTSD.

Figures

FIGURE 1—
FIGURE 1—
Participant flow diagram of US veterans seen at the Veterans Affairs Pacific Islands Health Care System, 2005–2012. Note. BMI = body mass index; HF = heart failure; VAPIHCS = Veterans Affairs Pacific Islands Health Care System.
FIGURE 2—
FIGURE 2—
Estimated cumulative hazard of heart failure, by PTSD status, among US veterans seen at the Veterans Affairs Pacific Islands Health Care System, 2005–2012. Note. PTSD = posttraumatic stress disorder; VAPIHCS = Veterans Affairs Pacific Islands Health Care System.
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