Combat exposure may increase risk of heart disease

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 - Gulf War Helmet

Military deployments may increase the risk for coronary heart disease (CHD) among U.S. service members and veterans, a study published online March 11 in Circulation found.

Nancy F. Crum-Cianflone, MD, MPH, of the Naval Health Research Center in San Diego, and co-investigators analyzed data from military members who participated in the Millennium Cohort Study between 2001 and 2008; the study assessed the health effects of military service. Crum-Cianflone and colleagues evaluated that study’s 60,025 participants for newly reported CHD and assessed the relationship between military deployment and post-traumatic stress disorder (PTSD) and CHD.

They also reviewed the medical records of active duty military members for CHD diagnosis codes. PTSD was assessed at baseline using responses to a screening survey. The researchers adjusted for other CHD risk factors, including body mass index, smoking, alcohol use, depression and anxiety.

Of the 60,025 participants, 627 (1 percent) newly reported CHD over an average of 5.6 years between the baseline and the most recent follow-up. They found that participation in military combat was associated with an increased risk for newly reported CHD (odds ratio [OR] 1.63) and having a diagnosis code for new-onset CHD (OR 1.93).

A positive PTSD screening was associated with self-reported CHD before adjusting for depression and anxiety, but not after. There was also no association between a positive PTSD screening and diagnosis codes.

In a sub-analysis of 23,794 participants who were active duty service members with CHD diagnosis codes, 342 (1.4 percent) had new-onset CHD. After adjusting for risk factors, those who were deployed and saw combat had about twice the risk of having a diagnosis for new-onset CHD than those deployed who had no combat exposure.

“Exposure to stressful events such as combat may play an important role in the development of CHD in a young, otherwise healthy population of U.S. service members,” the authors wrote. They suggested that future research examine the long-term impact of the conflicts in Iraq and Afghanistan.

For more in this topic, see "PTSD & Heart Disease: A Vicious Cycle" in Cardiovascular Business.