title: Risk for Incident Hypertension Associated With Posttraumatic Stress Disorder in Military Veterans and the Effect of Posttraumatic Stress Disorder Treatment.
abstract: Posttraumatic stress disorder (PTSD) increases cardiovascular disease and cardiovascular mortality risk. Neither the prospective relationship of PTSD to incident hypertension risk nor the effect of PTSD treatment on hypertension risk has been established.
  
  
  
  Data from a nationally representative sample of 194,319 veterans were drawn from the Veterans Administration (VA) roster of United States service men and women. This included veterans whose end of last deployment was from September 2001 to July 2010 and whose first VA medical visit was from October 1, 2001 to January 1, 2009. Incident hypertension was modeled as 3 events: (1) a new diagnosis of hypertension and/or (2) a new prescription for antihypertensive medication, and/or (3) a clinic blood pressure reading in the hypertensive range (≥140/90 mm Hg, systolic/diastolic). Posttraumatic stress disorder diagnosis was the main predictor. Posttraumatic stress disorder treatment was defined as (1) at least 8 individual psychotherapy sessions of 50 minutes or longer during any consecutive 6 months and/or (2) a prescription for selective serotonin reuptake inhibitor medication.
  
  
  
  Over a median 2.4-year follow-up, the incident hypertension risk independently associated with PTSD ranged from hazard ratio (HR), 1.12 (95% confidence interval [CI], 1.08-1.17; p < .0001) to HR, 1.30 (95% CI, 1.26-1.34; p < .0001). The interaction of PTSD and treatment revealed that treatment reduced the PTSD-associated hypertension risk (e.g., from HR, 1.44 [95% CI, 1.38-1.50; p < .0001] for those untreated, to HR, 1.20 [95% CI, 1.15-1.25; p < .0001] for those treated).
  
  
  
  These results indicate that reducing the long-term health impact of PTSD and the associated costs may require very early surveillance and treatment.
authors.affiliation: From the VA Connecticut Healthcare System, West Haven, CT (Burg, Brandt, Buta, Bathulapalli, Haskell); Yale University School of Medicine, New Haven, CT (Burg, Brandt, Buta, Dziura, Haskell); and Center for Behavioral Cardiovascular Health, Columbia University School of Medicine, New York, NY (Burg, Schwartz, Edmondson).
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Burg
authors.forename: Cynthia
authors.initials: C
authors.lastname: Brandt
authors.forename: Eugenia
authors.initials: E
authors.lastname: Buta
authors.forename: Joseph
authors.initials: J
authors.lastname: Schwartz
authors.forename: Harini
authors.initials: H
authors.lastname: Bathulapalli
authors.forename: James
authors.initials: J
authors.lastname: Dziura
authors.forename: Donald E
authors.initials: DE
authors.lastname: Edmondson
authors.forename: Sally
authors.initials: S
authors.lastname: Haskell
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008297:Male; D012306:Risk; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult