Posttraumatic stress disorder and cardiovascular disease: A prospective US military cohort study

Introduction: Recent research has suggested an association between PTSD and increased risk for incident coronary heart disease (CHD) and other cardiovascular diseases but those conducted among veterans have been largely limited to non-population-based samples. With ongoing military operations in support of Iraq and Afghanistan and increasing numbers of combat exposed veterans returning with PTSD symptoms greater understanding of the association between PTSD and CHD in the context of military deployment is imperative.

Methods: A representative sample of US service members, including active-duty and Reserve/National Guard members was invited to participate in a 21-year longitudinal study, the Millennium Cohort Study. A total of 108,157 consenting participants completed a baseline questionnaire from 2001-2003 (panel 1) or 2004-2006 (panel 2) and were re-surveyed at 3–year intervals in 2004-6 (panel 1) and 2007-8 (panels 1&2). A generalized linear mixed model was used to assess the temporal relationship of newly reported CHD with PTSD and military deployment, while adjusting for potential confounders.

Results: Since 2001, nearly 50% of participants have deployed, while up to 10% of combat deployers have reported new-onset PTSD symptoms. Of the 77,090 participants who completed a baseline and either a first or second follow-up questionnaire, 0.7% newly-reported CHD, while 3.0% newly-reported cardiovascular diseases. Longitudinal analyses are ongoing.

Conclusion: This is the first study to prospectively assess the relationship of military deployment with CHD in a representative US military population. PTSD and cardiovascular diseases remain important health concerns for US service members.