title: Posttraumatic stress disorder and incident heart failure among a community-based sample of US veterans.
abstract: OBJECTIVE
  We investigated the association between posttraumatic stress disorder (PTSD) and incident heart failure in a community-based sample of veterans.
  
  
  METHODS
  We examined Veterans Affairs Pacific Islands Health Care System outpatient medical records for 8248 veterans between 2005 and 2012. We used multivariable Cox regression to estimate hazard ratios and 95% confidence intervals for the development of heart failure by PTSD status.
  
  
  RESULTS
  Over a mean follow-up of 7.2 years, veterans with PTSD were at increased risk for developing heart failure (hazard ratio [HR] = 1.47; 95% confidence interval [CI] = 1.13, 1.92) compared with veterans without PTSD after adjustment for age, gender, diabetes, hyperlipidemia, hypertension, body mass index, combat service, and military service period. Additional predictors for heart failure included age (HR = 1.05; 95% CI = 1.03, 1.07), diabetes (HR = 2.54; 95% CI = 2.02, 3.20), hypertension (HR = 1.87; 95% CI = 1.42, 2.46), overweight (HR = 1.72; 95% CI = 1.25, 2.36), obesity (HR = 3.43; 95% CI = 2.50, 4.70), and combat service (HR = 4.99; 95% CI = 1.29, 19.38).
  
  
  CONCLUSIONS
  Ours is the first large-scale longitudinal study to report an association between PTSD and incident heart failure in an outpatient sample of US veterans. Prevention and treatment efforts for heart failure and its associated risk factors should be expanded among US veterans with PTSD.
authors.affiliation: Samit S. Roy and Randi E. Foraker are with the Division of Epidemiology, College of Public Health, Ohio State University, Columbus. Samit Sunny Roy is also with the Lillehei Clinical Research Unit, Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis. Alyssa J. Mansfield is with the National Center for PTSD, Pacific Islands Division, and Richard A. Girton is with the Department of Nephrology, Department of Veterans Affairs, VA Pacific Islands Health Care System, Honolulu, HI.
authors.forename: Samit S
authors.initials: SS
authors.lastname: Roy
authors.forename: Randi E
authors.initials: RE
authors.lastname: Foraker
authors.forename: Richard A
authors.initials: RA
authors.lastname: Girton
authors.forename: Alyssa J
authors.initials: AJ
authors.lastname: Mansfield
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010139:Pacific Islands / Q000453:epidemiology; D044469:Racial Groups; D012307:Risk Factors; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D013997:Time Factors; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*