PTSD improvement and incident cardiovascular disease in more than 1000 veterans

Jeffrey F. Scherrer, Joanne Salas, F. David Schneider, Matthew J. Friedman, Carissa van den Berk-Clark, Kathleen M. Chard, Sonya B. Norman, Patrick J. Lustman, Peter Tuerk, Paula P. Schnurr, Beth E. Cohen

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Posttraumatic stress disorder (PTSD) is associated with increased risk for cardiovascular disease (CVD). Whether clinically meaningful PTSD improvement is associated with lowering CVD risk is unknown. METHODS: Eligible patients (n = 1079), were 30-70 years old, diagnosed with PTSD and used Veterans Health Affairs PTSD specialty clinics. Patients had a PTSD Checklist score (PCL) ≥ 50 between Fiscal Year (FY) 2008 and FY2012 and a second PCL score within 12 months and at least 8 weeks after the first PCL ≥ 50. Clinically meaningful PTSD improvement was defined by ≥20 point PCL decrease between the first and second PCL score. Patients were free of CVD diagnoses for 1 year prior to index. Index date was 12 months following the first PCL. Follow-up continued to FY2015. Cox proportional hazard models estimated the association between clinically meaningful PTSD improvement and incident CVD and incident ischemic heart disease (IHD). Sensitivity analysis stratified by age group (30-49 vs. 50-70 years) and depression. Confounding was controlled using propensity scores and inverse probability of exposure weighting. RESULTS: Patients were 48.9 ± 10.9 years of age on average, 83.3% male, 60.1% white, and 29.5% black. After controlling for confounding, patients with vs. without PTSD improvement did not differ in CVD risk (HR = 1.08; 95%CI: 0.72-1.63). Results did not change after stratifying by age group or depression status. Results were similar for incident IHD. CONCLUSIONS: Over a 2-7 year follow-up, we did not find an association between clinically meaningful PTSD improvement and incident CVD. Additional research is needed using longer follow-up.

Original languageEnglish (US)
Number of pages1
JournalJournal of Psychosomatic Research
Volume134
DOIs
StatePublished - Jul 1 2020

Keywords

  • Cardiovascular disease
  • Epidemiology
  • Posttraumatic stress disorder
  • Psychotherapy
  • Veterans

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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  • Cite this

    Scherrer, J. F., Salas, J., Schneider, F. D., Friedman, M. J., van den Berk-Clark, C., Chard, K. M., Norman, S. B., Lustman, P. J., Tuerk, P., Schnurr, P. P., & Cohen, B. E. (2020). PTSD improvement and incident cardiovascular disease in more than 1000 veterans. Journal of Psychosomatic Research, 134. https://doi.org/10.1016/j.jpsychores.2020.110128