Heart Disease Center

By Karen Pallarit

Veterans more likely to have cardiac problems:  Combat Stress Can Be Hard on the Heart

(HealthDay News) -- Add the stress of combat to the list of risk factors for a heart attack.

In a study first presented at a meeting of the American Psychosomatic Society, researchers reported that Vietnam veterans who suffered from post-traumatic stress disorder were six times more likely than other vets to suffer a heart attack.

Lead researcher Joseph Boscarino, a Vietnam combat veteran himself, said the findings suggest that post-traumatic stress boosts heart attack risk, just as smoking or high blood pressure does.

"This is a pretty powerful indication that something is going on that puts people at high risk," Boscarino told HealthDay.

Post-traumatic stress is a psychiatric disorder that can occur in the wake of life-threatening events, including military combat. People who suffer from this type of stress often relive the experience through nightmares and flashbacks, according to the Department of Veterans Affairs' (VA) National Center for Post-Traumatic Stress Disorder. Other symptoms, including sleep problems and feeling detached or estranged, can be severe and prolonged, interfering with a person's daily life.

Boscarino, a senior scientist at the New York Academy of Medicine, looked at 12 studies involving more than 50,000 people exposed to the stress of war, disasters, child abuse and sexual assault. All of the evidence pointed to a link between stress and heart disease later in life.

Then, using data from a 1986 national study, he reviewed medical records for 2,490 Vietnam veterans, 54 of whom suffered from post-traumatic stress disorder.

Electrocardiograms confirmed their higher risk for heart attack. After adjusting for factors such as alcohol abuse and smoking, men suffering from the worst cases of post-traumatic stress had even higher heart attack rates.

It isn't clear why stress experienced two decades after the initial event would boost heart attack risk, but Boscarino speculated that the body's increased secretion of stress hormones may contribute to clogged arteries.

Seeking treatment for post-traumatic stress is key, the VA says. Without intervention, symptoms will persist over the long-term. And there are a variety of psychotherapy treatments and medications that have been shown to be helpful.

It's also wise advice for health overall. The American Heart Association reports growing evidence of a relationship between stress and risk for cardiovascular disease.  But until there's more data on the stress-and-heart disease connection, experts recommend taking steps to lower other confirmed risk factors for heart attack:

.  Manage your blood pressure.

. Get your cholesterol levels in check.

.  Stop smoking.

.  Maintain a healthy weight.

.  Control your blood sugar.

.  Exercise.

On the Web

Learn more about combat stress by visiting the National Center for Post-Traumatic Stress Disorders.

Page 4 (Printed version)

Page 5 (Printed version)

Combat Veterans Pay

a Price Decades Later

By Ed Edelson

SATURDAY, April 30 (HealthDay News) -- Combat can take a lasting toll on veterans, making them more likely to drink heavily and smoke decades after battle, a new study finds.

Veterans of World War II, Korea

and Vietnam who had seen combat were 60 percent more likely to be heavy drinkers than those who had not. And they were four times more likely to be heavy drinkers than men who never served in the armed forces, according to the study.

Similarly, combat veterans were 20 percent more likely to be heavy smokers than veterans who did not see combat, and 1.9 times more likely to smoke than non-veterans, the study found.

The research, by Anne-Marie Johnson, a doctoral candidate in epidemiology at the University of North Carolina School of Public Health, was to be presented Saturday at the American Heart Association's annual conference on cardiovascular disease epidem-iology and prevention, in Washington, D.C.

The findings suggest that combat exposure may have long-term adverse effects on heart health.

"I would assume that combat, seeing people killed and killing people, affects behavior," Johnson said. "My belief is that major combat is so traumatic that it has that effect."

Smoking clearly has been identified as a major risk factor for heart disease and stroke,

not to mention lung cancer. And while moderate drinking -- no more than two drinks a day for a man, one for a woman -- is regarded as safe and possibly beneficial by the American Heart Association, heavy drinking can lead to a variety of health problems.

While the study included only veterans of past wars, it's likely the same effects will be seen in troops now fighting in Iraq, Johnson said. A Department of Defense study published last year found that 17 percent of soldiers in Army and Marine combat units in Iraq had signs of major depression, generalized anxiety, substance abuse or post-traumatic stress disorder.

The new study also found that combat service affected physical behavior -- combat veterans were more likely to be obese than veterans who did not see action or non-veterans.

The findings come from a long-running study funded by the National Heart, Lung, and Blood Institute. Johnson and her colleagues reviewed questionnaires from more than 5,000 men, 22 percent of whom were combat veterans. Their answers about lifestyle and heart risk factors were compared to those answers given by the 40 percent of men who were veterans but had not seen combat and the 38 percent of men who never served in the military.

The questioning began long after service, in 1987, when the men were 44 to 66 years old.

Women were not included in the analysis because there were few female veterans in the study population, Johnson said.

Combat service also had long-lasting effects on a man's career, the study found.

(CONTINUED NEXT PAGE)

3/3 RVN Newsletter  Vol 1, Issue 6