Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 62, Issue 11, Pages 970-978Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2013.04.085
Keywords
cardiovascular diseases; epidemiology; risk factors; stress
Categories
Funding
- National Institutes of Health [K24HL077506, R01 HL68630, R01 AG026255, K24 MH076955, R21HL093665-01A1S1]
- American Heart Association [0245115N]
- National Center for Advancing Translational Sciences of the National Institutes of Health [UL1TR000454]
- Emory University General Clinical Research Center [MO1-RR00039]
- Vietnam Era Twin (VET) Registry
Ask authors/readers for more resources
Objectives The aim of this study was to determine whether post-traumatic stress disorder (PTSD) is associated with coronary heart disease (CHD) using a prospective twin study design and objective measures of CHD. Background It has long been hypothesized that PTSD increases the risk of CHD, but empirical evidence using objective measures is limited. Methods We conducted a prospective study of middle-aged male twins from the Vietnam Era Twin Registry. Among twin pairs without self-reported CHD at baseline, we selected pairs discordant for a lifetime history of PTSD, pairs discordant for a lifetime history of major depression, and pairs without either condition. All underwent a clinic visit after a median follow-up of 13 years. Outcomes included clinical events (myocardial infarction, other hospitalizations for CHD and coronary revascularization) and quantitative measures of myocardial perfusion by [N-13] ammonia positron emission tomography, including a stress total severity score and coronary flow reserve. Results A total of 562 twins (281 pairs) with a mean age of 42.6 years at baseline were included in this study. The incidence of CHD was more than double in twins with PTSD (22.6%) than in those without PTSD (8.9%; p < 0.001). The association remained robust after adjusting for lifestyle factors, other risk factors for CHD, and major depression (odds ratio: 2.2; 95% confidence interval: 1.2 to 4.1). Stress total severity score was significantly higher (+95%, p = 0.001) and coronary flow reserve was lower (-0.21, p = 0.02) in twins with PTSD than in those without PTSD, denoting worse myocardial perfusion. Associations were only mildly attenuated in 117 twin pairs discordant for PTSD. Conclusions Among Vietnam-era veterans, PTSD is a risk factor for CHD. (C) 2013 by the American College of Cardiology Foundation
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available