Posttraumatic Stress Disorder and Incident Heart Failure Among a Community-Based Sample of US Veterans
Posttraumatic Stress Disorder and Incident Heart Failure Among a Community-Based Sample of US Veterans
复制标题
DOI：
10.2105/ajph.2014.302342
复制
发表时间：
2015-04-01
影响因子：
12.7
通讯作者：
Mansfield, Alyssa J.
中科院分区：
文献类型：
--
作者：
Roy, Samit S.;Foraker, Randi E.;Mansfield, Alyssa J.
目标.我们调查了创伤后应激障碍（PTSD）和突发性心力衰竭之间的关系，在社区为基础的样本的退伍军人。我们检查了2005年至2012年期间8248名退伍军人的退伍军人事务太平洋岛屿卫生保健系统门诊病历。我们使用多变量考克斯回归来估计创伤后应激障碍状态导致心力衰竭的风险比和95%置信区间。在平均7.2年的随访中，在调整了年龄、性别、糖尿病、高脂血症、高血压、体重指数、战斗服务和兵役时间后，与没有PTSD的退伍军人相比，患有PTSD的退伍军人发生心力衰竭的风险增加（风险比[HR] = 1.47; 95%置信区间[CI] = 1.13，1.92）。心力衰竭的其他预测因素包括年龄（HR = 1.05; 95% CI = 1.03，1.07），糖尿病（HR = 2.54; 95% CI = 2.02，3.20），高血压（HR = 1.87; 95% CI = 1.42，2.46），超重（HR = 1.72; 95%CI = 1.25，2.36）、肥胖（HR = 3.43; 95%CI = 2.50，4.70）、服兵役（HR = 4.99; 95%CI = 1.29，19.38）。我们的研究是第一个大规模的纵向研究，报告了创伤后应激障碍与美国退伍军人门诊样本中心力衰竭事件之间的关联。心力衰竭及其相关危险因素的预防和治疗工作应扩大美国退伍军人与创伤后应激障碍。
Objectives. We investigated the association between posttraumatic stress disorder (PTSD) and incident heart failure in a community-based sample of veterans.Methods. We examined Veterans Affairs Pacific Islands Health Care System outpatient medical records for 8248 veterans between 2005 and 2012. We used multivariable Cox regression to estimate hazard ratios and 95% confidence intervals for the development of heart failure by PTSD status.Results. Over a mean follow-up of 7.2 years, veterans with PTSD were at increased risk for developing heart failure (hazard ratio [HR] = 1.47; 95% confidence interval [CI] = 1.13, 1.92) compared with veterans without PTSD after adjustment for age, gender, diabetes, hyperlipidemia, hypertension, body mass index, combat service, and military service period. Additional predictors for heart failure included age (HR = 1.05; 95% CI = 1.03, 1.07), diabetes (HR = 2.54; 95% CI = 2.02, 3.20), hypertension (HR = 1.87; 95% CI = 1.42, 2.46), overweight (HR = 1.72; 95% CI = 1.25, 2.36), obesity (HR = 3.43; 95% CI = 2.50, 4.70), and combat service (HR = 4.99; 95% CI = 1.29, 19.38).Conclusions. Ours is the first large-scale longitudinal study to report an association between PTSD and incident heart failure in an outpatient sample of US veterans. Prevention and treatment efforts for heart failure and its associated risk factors should be expanded among US veterans with PTSD.