title: Traumatic stress and cardiopulmonary disease burden among low-income, urban heart failure patients.
abstract: BACKGROUND
  Traumatic events and posttraumatic stress disorder (PTSD) are associated with increased risk for cardiopulmonary disease (CPD) in veterans, men, and primarily White populations. Less is known about trauma, PTSD, and CPD burden among low-income, racial minority residents who are at elevated risk for trauma and PTSD. It was hypothesized that traumatic events and PTSD would be significantly associated with CPD burden among low-income, racial minority residents.
  
  
  METHODS
  We evaluated cross-sectional relationships between traumatic events, PTSD, depression, and CPD burden in 251 low-income, urban, primarily Black adults diagnosed with heart failure. Data were analyzed using bivariate analyses, logistic and linear regression.
  
  
  RESULTS
  Forty-three percent endorsed at least one traumatic event. Twenty-one percent endorsed two or more traumatic events. In logistic regression analyses, traumatic events were associated with increased prevalence of coronary artery disease (adjusted odds=1.33, p<.05), hypertension (adjusted odds=1.28, p<.05), chronic obstructive pulmonary disease (adjusted odds=1.52, p<.01), and cardiac arrest (adjusted odds=1.27, p<.05). PTSD was also related to increased risk for chronic obstructive pulmonary disease (adjusted odds=1.22, p<.05) and was associated with earlier onset of heart failure (β=-.13, p<.05).
  
  
  CONCLUSIONS
  The study utilizes cross-sectional, self-report data.
  
  
  CONCLUSIONS
  Findings support the link between traumatic events, PTSD, and CPD burden in low-income, primarily Black patients with heart failure. Depression appears to be less closely linked to CPD burden, despite receiving significant attention in the literature. The accumulation of traumatic events may exacerbate CPD burden among urban, low-income, racial minority residents with heart failure; findings highlight the importance of PTSD screening.
authors.affiliation: Rush University Medical Center, United States.
authors.forename: April
authors.initials: A
authors.lastname: Taylor-Clift
authors.affiliation: Rush University Medical Center, United States. Electronic address: lucie_holmgreen@rush.edu.
authors.forename: Lucie
authors.initials: L
authors.lastname: Holmgreen
authors.affiliation: Rush University Medical Center, United States.
authors.forename: Stevan E
authors.initials: SE
authors.lastname: Hobfoll
authors.affiliation: Rush University Medical Center, United States.
authors.forename: James I
authors.initials: JI
authors.lastname: Gerhart
authors.affiliation: Lake Forest College and Rush University Medical Center, United States.
authors.forename: DeJuran
authors.initials: D
authors.lastname: Richardson
authors.affiliation: Schulich School of Medicine and Dentistry, Western University, Canada.
authors.forename: James E
authors.initials: JE
authors.lastname: Calvin
authors.affiliation: Rush University Medical Center, United States.
authors.forename: Lynda H
authors.initials: LH
authors.lastname: Powell
mesh_terms: D000368:Aged; D002641:Chicago / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data*; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology*
keywords: Cardiopulmonary health; Depression; Health disparities; Posttraumatic stress disorder; Traumatic stress