The association between PTSD and cardiovascular disease and its risk factors in male veterans of the Iraq/Afghanistan conflicts: a systematic review

TY - JOUR

T1 - The association between PTSD and cardiovascular disease and its risk factors in male veterans of the Iraq/Afghanistan conflicts

T2 - a systematic review

AU - Dyball, Daniel

AU - Evans, Sarah Caroline Mary

AU - Boos, Christopher J

AU - Stevelink, Sharon

AU - Fear, Nicola Townsend

PY - 2019

Y1 - 2019

N2 - Military personnel with Post-Traumatic Stress Disorder (PTSD) can experience high levels of mental and physical health comorbidity, potentially indicating a high level of functional impairment that can impact on both military readiness and later ill-health. There is strong evidence to implicate PTSD as a contributory factor to Cardiovascular Disease (CVD) among serving personnel and veterans. This systematic review focusses on the association between PTSD and cardiovascular disease/risk factors in male, military serving and ex-serving personnel who served in the Iraq/Afghanistan conflicts. PUBMED, MEDLINE, PILOTS, EMBASE, PSYCINFO and PSYCARTICLES were searched using PRISMA guidelines. Three hundred and forty-three records were identified, of which twenty articles were selected. PTSD was positively associated with the development of CVD, specifically circulatory diseases, including hypertension. PTSD was also positively associated with the following risk factors: elevated heart rate tobacco use, dyslipidaemia and obesity. Conflicting data is presented regarding heart rate variability and inflammatory markers. Future studies would benefit from a standardised methodological approach to investigating PTSD and physical health manifestations. It is suggested that clinicians offer health advice for CVD at an earlier age for ex-/serving personnel with PTSD.

AB - Military personnel with Post-Traumatic Stress Disorder (PTSD) can experience high levels of mental and physical health comorbidity, potentially indicating a high level of functional impairment that can impact on both military readiness and later ill-health. There is strong evidence to implicate PTSD as a contributory factor to Cardiovascular Disease (CVD) among serving personnel and veterans. This systematic review focusses on the association between PTSD and cardiovascular disease/risk factors in male, military serving and ex-serving personnel who served in the Iraq/Afghanistan conflicts. PUBMED, MEDLINE, PILOTS, EMBASE, PSYCINFO and PSYCARTICLES were searched using PRISMA guidelines. Three hundred and forty-three records were identified, of which twenty articles were selected. PTSD was positively associated with the development of CVD, specifically circulatory diseases, including hypertension. PTSD was also positively associated with the following risk factors: elevated heart rate tobacco use, dyslipidaemia and obesity. Conflicting data is presented regarding heart rate variability and inflammatory markers. Future studies would benefit from a standardised methodological approach to investigating PTSD and physical health manifestations. It is suggested that clinicians offer health advice for CVD at an earlier age for ex-/serving personnel with PTSD.

KW - Afghanistan

KW - Iraq

KW - cardiovascular diseases

KW - military personnel

KW - post-traumatic

KW - stress disorder

UR - http://www.scopus.com/inward/record.url?scp=85067242562&partnerID=8YFLogxK

U2 - 10.1080/09540261.2019.1580686

DO - 10.1080/09540261.2019.1580686

M3 - Review article

SN - 0954-0261

VL - 31

SP - 34

EP - 48

JO - International Review of Psychiatry

JF - International Review of Psychiatry

IS - 1

ER -