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Samit Roy MSPH Thesis.pdf (1.07 MB)

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Posttraumatic Stress Disorder and Incident Heart Failure in U.S. Veterans

Roy, Samit Sunny
http://rave.ohiolink.edu/etdc/view?acc_num=osu1373654215

Abstract Details

2013, Master of Science, Ohio State University, Public Health.
Introduction: Veterans are a population at increased risk of developing posttraumatic stress disorder (PTSD). Evidence suggests PTSD is a causal determinant for adverse physical health outcomes, specifically cardiovascular disease (CVD). However, there exists a gap in the literature regarding the association between PTSD and heart failure (HF). The purpose of this study was to determine whether Veterans with diagnosed PTSD are at increased risk for developing heart failure (HF) compared to Veterans without PTSD after adjusting for known risk factors for PTSD and HF. Methods: We examined the association between PTSD and HF in a sample of 11,864 Veterans using medical records from 2002-2012 obtained from the Veterans Affairs Pacific Islands Healthcare System (VAPIHCS). We assessed for continuous use of VAPIHCS services throughout the study period to construct the study cohort. We included Veterans free of HF at study baseline (2005) and assessed for PTSD and presence of service-related and clinical covariates at that time. Multivariable Cox regression was used to estimate hazard ratios and 95% confidence intervals (HR; 95% CI) and to account for known risk factors for PTSD and HF. Results: Over a mean follow-up of 7.2 years, Veterans with PTSD were at significantly increased risk for developing HF (1.47; 1.13-1.92) compared to Veterans without PTSD in a model including age, gender, diabetes, hyperlipidemia, hypertension, combat service, period of military service, and body mass index (BMI). Other significant predictors of HF included age (1.05; 1.03-1.07), diabetes (2.54; 2.02-3.20), hypertension (1.87; 1.42-2.46), combat service (4.99; 1.29-19.38), and BMI (Overweight: 1.72; 1.25-2.36; Obese: 3.43; 2.50-4.70). Discussion: Our study is the first large-scale longitudinal study to investigate the association between PTSD and incident HF among Veterans. We found that PTSD is associated with increased risk of developing HF in Veterans, and this association persisted after controlling for known risk factors related to PTSD and HF. Our findings suggest that prevention and treatment efforts for CVD and its associated risk factors should be redoubled among Veterans with PTSD.
Randi Foraker, PhD (Advisor)
Randall Harris, MD, PhD (Committee Member)
Alyssa Mansfield, PhD, MPH (Committee Member)
47 p.
Epidemiology; Public Health
PTSD, heart failure, Veterans, CVD

Recommended Citations

Citations

  • Roy, S. S. (2013). Posttraumatic Stress Disorder and Incident Heart Failure in U.S. Veterans [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1373654215

    APA Style (7th edition)

  • Roy, Samit. Posttraumatic Stress Disorder and Incident Heart Failure in U.S. Veterans. 2013. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1373654215.

    MLA Style (8th edition)

  • Roy, Samit. "Posttraumatic Stress Disorder and Incident Heart Failure in U.S. Veterans." Master's thesis, Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1373654215

    Chicago Manual of Style (17th edition)

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© 2013, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.