Male twin Vietnam War veterans with posttraumatic stress disorder were more than twice as likely to develop coronary heart disease vs. those without PTSD, according to recent results of a prospective study supported by the NIH.
The study followed 281 pairs of male twins who were Vietnam veterans. Twin pairs were selected in which at least one twin had PTSD or depression (n=137) and pairs in which both twins did not have PTSD (n=425). PTSD was measured in the twins based on the Diagnostic Interview Schedule for psychiatric disorders. Of the participants, there were no differences in demographic characteristics, military variables and coronary heart disease (CHD) risk factors, and those with a previous history of cardiovascular disease (CVD) were excluded.
Median follow-up visits of 13 years assessed for incidences of CVD and measurements of positron emission tomography myocardial perfusion and myocardial blood flow. Overall, CHD occurred in 22.6% of the participants with PTSD and in 8.9% of those without PTSD. The increased risk also was found in the subcategories of acute myocardial infarction, other hospitalization for CHD and revascularization procedures.
When assessing twin pairs individually, those who had brothers with PTSD were 90% more likely to have CHD than in those without (22.2% vs. 12.8%).
Because the participants with PTSD were more likely to smoke, drink alcohol and have a history of hypertension, these factors were adjusted for, yet still indicated that risk for CHD remained higher in those with PTSD. PTSD also indicated a higher stress total severity score and lower coronary flow reserve.
“Further studies should address mechanisms underlying the increased cardiovascular risk in persons with PTSD, as this information will help guide effective prevention and treatment strategies aimed at reducing cardiovascular morbidity and mortally in persons with PTSD,” the researchers wrote.
For more information:
Vaccarino V. J Am CollCardiol. 2013; [published online ahead of print June 25].
