Post-Traumatic Stress Boosts Heart Attack Risk

New study finds a link in Vietnam veterans

FRIDAY, March 5, 2004 (HealthDayNews) -- Combat veterans who suffer from post-traumatic stress disorder are six times more likely to suffer a heart attack than other vets, new research suggests.

The findings "give people another risk factor that has to be considered," just like smoking or high blood pressure, says lead researcher Joseph Boscarino, a senior scientist at the New York Academy of Medicine. "This is a pretty powerful indication that something is going on that puts people at high risk."

While the link between stress and heart disease may not seem surprising, Boscarino's study is unusual because it examines what happened two decades after a stressful event, in this case the Vietnam war. "It's really hard to do these studies because you can't get access to a population 20 years after these events occur," he says.

A Vietnam combat veteran himself, Boscarino presented his findings March 5 at the American Psychosomatic Society's annual meeting in Orlando, Fla.

Before he started examining veterans, Boscarino reviewed 12 studies that together analyzed the experiences of more than 50,000 people exposed to war, disasters, child abuse and sexual assault. He found all the research linked previous experience of stress to heart disease later in life.

Then, Boscarino analyzed the medical records of 2,490 Vietnam veterans who took part in a national study in 1986. At the time of the study, 54 of the veterans suffered from post-traumatic stress disorder.

By examining their electrocardiograms for signs of cardiovascular disease, Boscarino found those veterans were six times more likely to have had a heart attack.

Boscarino adjusted the findings to eliminate any effect from factors such as alcohol abuse and smoking. And the men who suffered from the worst cases of post-traumatic stress had even higher heart attack rates.

It's not clear why lingering stress boosted the risk of heart attack. Boscarino speculates the body's increased secretion of stress hormones may contribute to clogged arteries.

The link between stress and heart disease doesn't surprise Jim Schmidt, chief operating officer of the Maryland-based Sidran Institute, which helps people suffering from post-traumatic stress disorder.

"It's something that's been well known in the field, but has only been proven sporadically," Schmidt says. "If you ask anybody who works with trauma survivors, they're going to report an increase of physical symptoms of all kinds. Your body, like any machine, will wear out faster under stress than in a relaxed state."

Recovery programs offer the best hope of beating the stress symptoms, Schmidt says, but many sufferers don't seek help.

"Most people who have post-traumatic stress disorder are undiagnosed," he says. "They know they have these symptoms, which might be restlessness, trouble sleeping, nightmares and periods they can't remember. But most don't make the connection between those events and a prior traumatic event."

Once they seek counseling, however, the connection between the past and present "clicks," Schmidt says, as they realize "this is happening because this happened to me."

That, he says, "is one of the early steps toward recovery, understanding that the things happening to you are normal effects of exposure to trauma."

More information

For more information on post-traumatic stress disorder, visit the Sidran Institute. Its toll-free support line is at 888-825-8249. Or try the National Center for Post-Traumatic Stress Disorder.

SOURCES: Joseph Boscarino, Ph.D., M.P.H., senior scientist, New York Academy of Medicine, New York City; Jim Schmidt, chief operating officer, Sidran Institute, Towson, Md.; March 5, 2004, presentation, American Psychosomatic Society annual meeting, Orlando, Fla.
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