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BMJ Open. 2015 Dec 14;5(12):e009334. doi: 10.1136/bmjopen-2015-009334.

Associations between stress disorders and cardiovascular disease events in the Danish population.

Author information

1
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.
2
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
3
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
4
Clinical Excellence Research Center, Stanford University, Stanford, California, USA.
5
Department of Psychiatry, University of California, San Fransisco, California, USA.

Abstract

OBJECTIVES:

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.

DESIGN:

Prospective cohort study utilising Danish national registry data.

SETTING:

The general population of Denmark.

PARTICIPANTS:

PTSD (n=4724) and adjustment disorder (n=64,855) cohorts compared with the general population of Denmark from 1995 to 2011.

PRIMARY OUTCOME MEASURES:

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.

KEYWORDS:

CARDIOLOGY; EPIDEMIOLOGY; MENTAL HEALTH

PMID:
26667014
PMCID:
PMC4679888
DOI:
10.1136/bmjopen-2015-009334
[Indexed for MEDLINE]
Free PMC Article

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