title: Military combat and burden of subclinical atherosclerosis in middle aged men: the ARIC study.
abstract: BACKGROUND
  Studies of the cardiovascular consequences of combat stress are few and inconclusive.
  
  
  OBJECTIVE
  The association between combat exposure and subclinical atherosclerosis at Atherosclerosis Risk in Communities (ARIC) Study visits 1 (1987-1989) and 2 (1990-1992) was assessed among 5347 men from four U.S. communities.
  
  
  METHODS
  Measured an average of 36 years after military entry, carotid intima-media thickness (CIMT) and carotid plaque among non-combat veterans (n=2127) were compared with non-veterans (n=2042) and veterans reporting combat experience (n=1178).
  
  
  RESULTS
  Compared to non-combat veterans, non-veterans (risk difference (RD): 10.61; 95% confidence interval (CI): 0.81, 20.41) and combat veterans (RD: 12.79; 95% CI: 0.72, 24.86) had higher age-adjusted mean CIMT. Differences remained for combat veterans after adjustment for race, father's education and age at service entry but not years of service and for non-veterans after adjustment for race but not father's education. No differences in carotid plaque were noted.
  
  
  CONCLUSIONS
  Results do not suggest that combat has a long-term detrimental effect on subclinical atherosclerosis among men.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27514, USA. Anna_Johnson@unc.edu
authors.forename: Anna M
authors.initials: AM
authors.lastname: Johnson
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Rose
authors.forename: Glen H
authors.initials: GH
authors.lastname: Elder
authors.forename: Lloyd E
authors.initials: LE
authors.lastname: Chambless
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D017281:Cost of Illness; D005220:Fathers / Q000193:education; D006801:Humans; D016018:Least-Squares Analysis; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D014857:Warfare; D044465:White People / Q000706:statistics & numerical data