Military Combat and Risk of Coronary Heart Disease and Ischemic Stroke in Aging Men: The Atherosclerosis Risk in Communities (ARIC) Study

Purpose

To assess the long-term association of military combat stress with coronary heart disease (CHD) and ischemic stroke (IS).

Methods

The association between exposure to military combat and the occurrence of CHD and IS was assessed among 5,347 men in the Atherosclerosis Risk in Communities (ARIC) study. Outcomes were assessed an average of 36 years after entry into military service during the eras of World War II, the Korean War, and the Vietnam conflict.

Results

Veterans were more likely to be older, white, and of higher socioeconomic status than non-veterans. No differences in CHD period prevalence rates were noted among the three exposure groups, overall or by era of service. Associations between combat and ischemic stroke period prevalence may be modified by father's education, although confidence intervals were wide and event rates small.

Conclusions

Overall, middle-aged veterans with distant combat exposure are not at increased cardiovascular risk compared to those without combat exposure.

Key words: Combat, Veteran, Heart Disease, Ischemic Stroke, Cardiovascular Disease

Selected Abbreviations and Acronyms: ARIC, Atherosclerosis Risk in Communities, CI, confidence interval, CHD, coronary heart disease, CVD, cardiovascular disease, HDL, high-density lipoprotein, IS, ischemic stroke, LC-SES, Life Course Socioeconomic Status, Social Context and Cardiovascular Disease, LVH, left ventricular hypertrophy, MI, myocardial infarction, POW, prisoner of war, PP, period prevalence, PPR, period prevalence ratio, PTSD, post-traumatic stress disorder, SBP, systolic blood pressure, SES, socioeconomic status