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Pathways Linking Post-Traumatic Stress Disorder to Incident Ischemic Heart Disease in Women: Call to Action.
Ebrahimi, Ramin; Dennis, Paul A; Shroyer, Annie Laurie W; Tseng, Chi-Hong; Alvarez, Carlos A; Beckham, Jean C; Sumner, Jennifer A.
Afiliación
  • Ebrahimi R; Department of Medicine, University of California, Los Angeles, California, USA.
  • Dennis PA; Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.
  • Shroyer ALW; Veterans Affairs Durham Health Care System, Durham, North Carolina, USA.
  • Tseng CH; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
  • Alvarez CA; Department of Surgery, Northport Veterans Affairs Medical Center, New York, USA.
  • Beckham JC; Department of Surgery, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.
  • Sumner JA; Department of Medicine, University of California, Los Angeles, California, USA.
JACC Adv ; 3(1): 100744, 2024 Jan.
Article en En | MEDLINE | ID: mdl-38939802
ABSTRACT

Background:

Post-traumatic stress disorder (PTSD) is associated with increased rates of incident ischemic heart disease (IHD) in women.

Objectives:

The purpose of this study was to determine mechanisms of the PTSD-IHD association in women.

Methods:

In this retrospective longitudinal cohort study, data were obtained from electronic health records of all U.S. women veterans who were enrolled in Veterans Health Administration care from January 1, 2000 to December 31, 2017. Propensity score matching was used to match women with PTSD to women without PTSD on age, number of prior Veterans Health Administration visits, and presence of various traditional and nontraditional cardiovascular risk factors at index visit. Cox regression was used to model time until incident IHD diagnosis (ie, coronary artery disease, angina, or myocardial infarction) as a function of PTSD and potential mediating risk factors. Diagnoses of IHD, PTSD, and risk factors were defined by International Classification of Diseases-9th or -10th Revision, and/or Current Procedural Terminology codes.

Results:

PTSD was associated with elevated rates of developing each risk factor. Traditional risk factors (hypertension, hyperlipidemia, smoking, diabetes) accounted for 24.2% of the PTSD-IHD association, psychiatric risk factors (eg, depression, anxiety, substance use disorders) accounted for 33.8% of the association, and all 13 risk factors accounted for 48.5% of the association.

Conclusions:

Traditional IHD risk factors explained a quarter of the PTSD-IHD association in women veterans, and over half of the risk of IHD associated with PTSD remained unexplained even when adjusting for a wide range of risk factors. To be actionable, factors underlying the remaining PTSD-IHD association warrant timely investigation.
Palabras clave

Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: JACC Adv Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: JACC Adv Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos