title: Associations between stress disorders and cardiovascular disease events in the Danish population.
abstract: OBJECTIVE
  Post-traumatic stress disorder (PTSD) is a well-documented risk factor for cardiovascular disease (CVD). However, it is unknown whether another common stress disorder-adjustment disorder--is also associated with an increased risk of CVD and whether gender modifies these associations. The aim of this study was to examine the overall and gender-stratified associations between PTSD and adjustment disorder and 4 CVD events.
  
  
  METHODS
  Prospective cohort study utilising Danish national registry data.
  
  
  METHODS
  The general population of Denmark.
  
  
  METHODS
  PTSD (n=4724) and adjustment disorder (n=64,855) cohorts compared with the general population of Denmark from 1995 to 2011.
  
  
  METHODS
  CVD events including myocardial infarction (MI), stroke, ischaemic stroke and venous thromboembolism (VTE). Standardised incidence rates and 95% CIs were calculated.
  
  
  RESULTS
  Associations were found between PTSD and all 4 CVD events ranging from 1.5 (95% CI 1.1 to 1.9) for MI to 2.1 (95% CI 1.7 to 2.7) for VTE. Associations that were similar in magnitude were also found for adjustment disorder and all 4 CVD events: 1.5 (95% CI 1.4 to 1.6) for MI to 1.9 (95% CI 1.8 to 2.0) for VTE. No gender differences were noted.
  
  
  CONCLUSIONS
  By expanding beyond PTSD and examining a second stress disorder-adjustment disorder-this study provides evidence that stress-related psychopathology is associated with CVD events. Further, limited evidence of gender differences in associations for either of the stress disorders and CVD was found.
authors.affiliation: National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA Departments of Psychiatry and Epidemiology, Boston University, Boston, Massachusetts, USA Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jaimie L
authors.initials: JL
authors.lastname: Gradus
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Dóra Körmendiné
authors.initials: DK
authors.lastname: Farkas
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Svensson
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Vera
authors.initials: V
authors.lastname: Ehrenstein
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Lash
authors.affiliation: Clinical Excellence Research Center, Stanford University, Stanford, California, USA.
authors.forename: Arnold
authors.initials: A
authors.lastname: Milstein
authors.affiliation: Department of Psychiatry, University of California, San Fransisco, California, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Adler
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
mesh_terms: D000275:Adjustment Disorders / Q000150:complications*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications*; D020521:Stroke / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D054556:Venous Thromboembolism / Q000209:etiology* / Q000523:psychology; D055815:Young Adult
keywords: CARDIOLOGY; EPIDEMIOLOGY; MENTAL HEALTH