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A new study of U.S. veterans shows that the risk of heart attack is significantly higher in people with post-traumatic stress disorder (PTSD) or traumatic brain injury (TBI).
Past studies have shown that PTSD is a risk factor for heart disease and stroke. And with veterans having disproportionately higher rates for PTSD as well as TBI — which has become the so-called signature injury of the U.S. wars in Iraq and Afghanistan— they are especially vulnerable to experience heart attacks. It is estimated that 23% of veterans in those wars suffered a TBI.
The Department of Defense and the Defense and Veteran’s Brain Injury Center estimate that 22% of all combat casualties from these conflicts are brain injuries, compared to 12% of Vietnam related combat casualties. Moreover, according to data quoted by Statista, there were 61,131 cases of traumatic brain injury-related deaths in the U.S. in 2017.
In the new study, researchers from Kansas City VA Medical Center looked at data from 1998 to 2014 for more than 1 million veterans, many of whom had served in the Gulf War or the Iraq and Afghanistan wars.
In the study, they found that veterans with TBI had an especially higher risk of having a heart attack — more than two and a half times higher than those without TBI or PTSD. Also, veterans with PTSD were more than one and a half times more likely to have a heart attack than those without PTSD or TBI.
Quoted in Times Union, lead researcher Dr. Rishi Sharma, an assistant professor at the University of Missouri-Kansas City School of Medicine, reportedly said: “While the result itself was not surprising, what surprised me was the strength of the association. We didn’t expect the effect would be so pronounced.”
He explained how some veterans who had heart attacks were in their 40s. This finding was surprising since the average age for a person’s first heart attack for men is 66 and 72 for women.
“People in their 40s might not think they’re at risk for heart disease, but the study is showing us that veterans with PTSD or TBI need to watch out. Medical professionals need to start screening and assessing them earlier than the general population and referring them to a cardiologist if needed,” Dr. Sharma recommended.
Dr. Sharma also said that though studies have shown that when changes in the brain occur for any reason, whether it’s a stroke or TBI or PTSD or seizure, it can have a direct effect on the heart. However, the study didn’t explore why people with PTSD or TBI might suffer more heart attacks, so the results shed more light on what’s been called “the heart-brain connection.” “The brain cells under stress release epinephrine, or adrenaline, which affects cardiac cell receptors and may cause problems like arrhythmias or heart attack,” he explained.
Though he was not involved in the new study, the chief of cardiology at Orlando VA Healthcare System Dr. Mark Milunski said it’s still unclear whether PTSD or TBI act as the sole driver for heart attacks in veterans, or if other risk factors like smoking, diabetes and high blood pressure play a part.
“Further studies are needed to formulate clinical guidelines to determine risk and intervene to help reduce the incidence of heart attacks [in veterans],” he said.
The findings of the study conducted by the Kansas City VA Medical Center have been presented at the American Heart Association’s virtual Scientific Sessions and are currently considered preliminary, which will change one they’re published in a peer-reviewed journal.