Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study CONTEXT: Various correlates of posttraumatic stress disorder (PTSD), such as high levels of sympathetic activation and hypothalamic-pituitary-adrenal axis dysregulation, have been linked to arterial damage and coronary heart disease (CHD) risk. While psychological disturbance is frequently found among patients with cardiac disease, whether psychological problems precede or occur as a result of having a potentially fatal disease is not clear. To our knowledge, no prospective studies to date have evaluated whether PTSD is associated with increased risk of CHD. OBJECTIVE: To test the hypothesis that high levels of PTSD symptoms may increase CHD risk, using 2 different measures of PTSD. DESIGN: Prospective cohort study. SETTING: Community-dwelling men from the Greater Boston, Mass, area who served in the military. PARTICIPANTS: Data are from the Veterans Affairs Normative Aging Study. Men who completed either the Mississippi Scale for Combat-Related PTSD in 1990 (n = 1002) or the Keane PTSD scale in 1986 (n = 944) were included in the study. MAIN OUTCOME MEASURE: Incident CHD occurring during follow-up through May 2001. RESULTS: Levels of PTSD symptoms in this cohort were low to moderate. Men with preexisting CHD at baseline were excluded, and PTSD was measured with the Mississippi Scale for Combat-Related PTSD. For each SD increase in symptom level, men had age-adjusted relative risks of 1.26 (95\% confidence interval, 1.05-1.51) for nonfatal myocardial infarction and fatal CHD combined and 1.21 (95\% confidence interval, 1.05-1.41) for all of the CHD outcomes combined (nonfatal myocardial infarction, fatal CHD, and angina). Findings were replicated using the Keane PTSD scale and somewhat strengthened after controlling for levels of depressive symptoms. CONCLUSIONS: To our knowledge, this is the first study to demonstrate a prospective association between PTSD symptoms and CHD even after controlling for depressive symptoms. These results suggest that a higher level of PTSD symptoms may increase the risk of incident CHD in older men https://www.upress.umn.edu/test-division/bibliography/2000-2009/2007/kubzansky_prospective_2007 https://www.upress.umn.edu/logo.png

L.D. Kubzansky, K.C. Koenen, A. Spiro, P.S. Vokonas, and D. Sparrow (2007)

Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study

Arch.Gen.Psychiatry, 64(1):109-116.

Keywords

Activation
Age factors
Aged
Aged
Aging
Aging study
Angina
Cardiac disease
Cohort Studies
Combat disorders
Comorbidity
Confidence
Confidence interval
Coronary disease
Coronary heart disease
Diagnosis
Disease
Disturbance
Epidemiology
Fatal disease
Follow-up studies
Health care
Heart
Heart disease
Keane PTSD scale
Military
Mississippi Scale
Mississippi Scale for Combat Related PTSD
MMPI
Normative Aging Study
Older men
Patients
PTSD
PTSD Scale
Research
Risk
School
Stress
Symptoms
Test
University
Veteran
Veterans affairs

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Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study