Association of Posttraumatic Stress Disorder and Heart Disease in Women Veterans: Examining Risk Factors and Effects of Pharmacotherapy on Clinical Outcomes
Abstract
Heart disease and related illnesses, collectively called cardiovascular disease (CVD), are the number one cause of death among women in the United States, leading to one death every 1 minute and 19 seconds. In 2014, CVD claimed as many lives among U.S. women as cancer, chronic lower respiratory disease, and diabetes mellitus combined. Post-traumatic distress disorder (PTSD) is a potentially debilitating psychological disorder that may occur after a traumatic event, such as exposure to combat, violence, or loss of a loved one. Several studies, based on symptoms, have found that PTSD is associated with heart disease and other CVDs, suggesting – but not proving – that PTSD contributes to heart disease. To date, the vast majority of research on CVD and PTSD has been done on men, and more research examining the PTSD-CVD relationship in women is needed. Why is it important to focus on women Veterans? PTSD is more common, long-lasting, severe, and impairing in women than in men, occurring in about 10% of women in the general U.S. population – twice the rate of men. In women Veterans, it is even more common. Moreover, the symptoms and medical issues of CVD differ between women and men. Due to these differences, applying the findings of current studies to women is far from ideal. A recent study found 54% of U.S. women Veterans are at risk for CVD. There are over two million U.S. women Veterans, and the need for more research on how PTSD and CVD are related in women Veterans has been recognized by the Department of Defense. The overall goals of our research proposal directly address this need. In this research project, our main goals are to determine if and how PTSD is related to heart disease and other CVDs in women Veterans, how common it is, and examine what factors can increase the chances of getting CVD. Factors that increase risk can be environmental, behavioral, or biological (including physiological) and are called “risk factors.” Behavioral factors include smoking, alcohol consumption, and other activities while physiological factors include high blood pressure, high cholesterol, and such. The biological step-by-step processes that lead from PTSD to CVD are called “pathophysiological mechanisms.” Our project is groundbreaking in a number of ways. First, this project will be the largest ever conducted on this topic, and it will look at the time delay between PTSD diagnosis and when CVD begins. Second, it is the first study to examine only women Veterans at this large scale. Third, a large number of different CVDs, such as heart attack, stroke, abnormal heart beat, and many others, will be considered. Fourth, a wide variety of potential mechanisms will be assessed, including female-specific risk factors (such as pregnancy-related issues) and neuroendocrine disorders (the neuroendocrine system releases hormones). And fifth, various drugs used by women Veterans with PTSD will be examined, including female-specific treatments (e.g., hormone replacement, oral contraceptives). To conduct this research, we will use the medicals records stored at the Department of Veterans Affairs (VA), the largest healthcare system in U.S. All information that can be used to identify a person will be removed and never seen, except by only a few authorized research personnel in order to extract pertinent data. The research team is led by the Principal Investigator, Dr. Ramin Ebrahimi (VA and University of California, Los Angeles [UCLA]), a cardiologist with expertise in heart disease and PTSD, and the following experts: Dr. Jennifer Sumner (Columbia University), a clinical psychologist with expertise on stress, PTSD, and CVD in women; Dr. Jean Beckham (VA and Duke University), a clinical psychologist with expertise in PTSD and CVD; Dr. Elizabeth Yano (VA and UCLA), a sociologist with over 30 years of expertise in research relating to women’s health; Drs. Paul Dennis (Duke University) and Chi-Hong Tseng (UCLA), who are
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810725
Entities
People
- Ramin Ebrahimi
Organizations
- United States Army
- University of California, Los Angeles