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PTSD increases risk for heart failure among veterans

Veterans with post-traumatic stress disorder may be at greater risk of developing heart failure, even after adjusting for factors such as combat service and period of military service, according to recent research.

“There are many theories as to how exactly [post-traumatic stress disorder] contributes to heart disease,” Alyssa J. Mansfield, PhD, MHA, MPH, of the National Center for PTSD, Pacific Islands Division, stated in a press release. “Overall, the evidence to date seems to point in the direction of a causal relationship.”

Alyssa J. Mansfield

Mansfield and colleague used outpatient medical records from the Veterans Affairs Pacific Islands Health Care System to identify 8,248 veterans who sought care between 2005 and 2012. The researchers evaluated the veterans’ medical records based on risk factors associated with heart failure (hypertension, BMI, age, diabetes and hyperlipidemia), PTSD (anxiety and depression), and both heart failure and PTSD (substance use and tobacco use). They also analyzed whether the veterans had seen combat and which conflict the veterans had participated in, ranging from World War II to the Persian Gulf Wars.

The researchers found that veterans with PTSD were more likely to develop heart failure over the 7.2-year mean follow-up period (HR = 1.47; 95% CI, 1.13-1.92) compared with veterans without PTSD. This risk for heart failure remained after adjusting for factors such as age, gender, BMI, diabetes, hyperlipidemia, hypertension, period of military service and combat service. Mansfield and colleagues noted that veterans with PTSD were more likely to have seen combat, and were more likely to have anxiety, depression, adjustment or substance use disorders and also used tobacco.

Other predictors for heart failure in the study included combat service (HR = 4.99; 95% CI, 1.29-19.38), being overweight (HR = 1.72; 95% CI, 1.25-2.36), obesity (HR = 3.43; 95% CI, 2.5-4.7), diabetes (HR = 2.54; 95% CI, 2.02-3.2), hypertension (HR = 1.87; 95% CI, 1.42-2.46), and age (HR = 1.05; 95% CI, 1.03-1.07).

Disclosure: The researchers report no relevant financial disclosures.