Military combat and burden of subclinical atherosclerosis in middle aged men: the ARIC study.
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.
Johnson
Anna M
AM
Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27514, USA. Anna_Johnson@unc.edu
Rose
Kathryn M
KM
Elder
Glen H
GH
Chambless
Lloyd E
LE
Kaufman
Jay S
JS
Heiss
Gerardo
G
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