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Post-Traumatic Stress Disorder (PTSD) and Ischemic Heart Disease (IHD)

Examining the link between PTSD and ICD in female veterans

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The majority of previous studies on the connection between Post-Traumatic Stress Disorder (PTSD) and Ischemic Heart Disease (IHD) have focused on male populations.

PTSD is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event; IHD is a term given to heart problems caused by the narrowing of heart arteries.

An early study led by Dr. Viola Vaccarino of Emory University established a link between PTSD and heart disease among Vietnam veterans.

"One surprising finding was that the increased risk that we saw in veterans with PTSD was not due to ‘conventional' coronary heart disease risk factors, such as obesity or blood lipids,"  explained Vaccarino in a 2013 interview.

"The increase also was not explained by adverse health behaviors such as smoking and physical inactivity. This information will aid in future research that addresses the underlying mechanisms of increased cardiovascular risks in those with PTSD,"' she concluded.

It was not until recently that researchers acted on some of this information and began to examine the link between PTSD and ICD in female veterans.

"PTSD is a known risk factor for incident ischemic heart disease in male populations.... However, this connection in women veterans is understudied,"  Kenny Walter wrote in an article entitled PTSD Linked to Increased Risk of Ischemic Heart Disease in Women Veterans.

In order to determine whether PTSD is associated with incident IHD in women veterans, Dr. Ramin Ebrahimi, Department of Medicine, Cardiology Section, Veterans Affairs Greater Los Angeles Health Care System, led a team which studied this link.

In a longitudinal study conducted from January 1, 2000 to December 31, 2017 which included 398,769 female veterans (132,923 with PTSD to 265,846 without PTSD), results showed that women with PTSD had a 44 percent higher rate of developing incident IHD than women without PTSD. Data from the study were analyzed from October 1, 2018 to October 30, 2020.

Ebrahimi's team also used propensity score matching to account for various risk factors, to include traditional and female-specific cardiovascular risk factors and mental and physical health disorders.

Researchers found that female veterans with PTSD were at an increased risk of developing IHD.

"The greatest elevation in incident IHD risk was seen among female veterans with PTSD who were of younger age (particularly those aged younger than 40 years), Black race, and Hispanic/Latino ethnicity, as well as those exposed to military sexual trauma,"  reported Ebrahimi in a November 12, 2020 article which appeared in Practice Update.

"Our results suggest that health care professionals should consider more routine and earlier screening for cardiovascular disorders in women with PTSD,"  he concluded.

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