Iraq and Afghanistan veterans with mental health problems have higher heart disease risk
Veterans of Iraq and Afghanistan with post-traumatic stress disorder and other mental health diagnoses have two to three times the rate of heart disease risk factors compared with veterans without such diagnoses, according to a study by researchers at the San Francisco VA Medical Center.
The study of 303,223 Iraq and Afghanistan veterans who were new users of VA health care showed that veterans with PTSD and other mental health diagnoses had significantly higher rates of tobacco use, high blood pressure, high cholesterol, and obesity than veterans without any mental health diagnoses.
The study appears as a Research Letter in the August 5, 2009 issue of the Journal of the American Medical Association.
“These results suggest a need for long-term studies to better understand the link between mental health problems and increased heart disease risk,” says lead author Beth E. Cohen, MD, MAS, a staff physician at SFVAMC and an assistant professor of medicine at UCSF. “These are young men and women, most of whom do not yet have heart disease. If we can learn why they are at greater risk now, we can find ways to help them avoid heart disease later in life.”
Cohen explains that the current study was not designed to determine whether mental health disorders caused the higher rates of cardiac risk factors.
The researchers used data from the VA OIF/OEF (Operation Iraqi Freedom/Operation Enduring Freedom) Roster, which contains information on Iraq and Afghanistan veterans who accessed VA health care for the first time between October 7, 2001 – the beginning of the United States war in Afghanistan – and September 30, 2008. The average age of the subjects was 31, and 88 percent were men.
PTSD was the most common mental health diagnosis, present in 24 percent of the study population. Most patients with PTSD had a co-occurring mental health diagnosis such as depression (53 percent), anxiety disorder (29 percent), adjustment disorder (26 percent), or alcohol use disorder (22 percent).
Co-authors of the study were Charles Marmar, MD, Li Ren, MS, Daniel Bertenthal, MPH, and senior author Karen Seal, MD, MPH, of SFVAMC and UCSF.
The study was supported by funds from the Department of Veterans Affairs and the National Institutes of Health. Some of the funds were administered by the Northern California Institute for Research and Education.
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SFVAMC has the largest medical research program in the national VA system, with more than 200 research scientists, all of whom are faculty members at UCSF.
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