Veterans who come home from Iraq and Afghanistan with posttraumatic stress disorder (PTSD) and other mental health diagnoses are hit with a double whammy: They also have greater risk factors for heart disease, according to a report in the Journal of the American Medical Association.

PTSD related to military service has been linked to heart disease in the past, but, to the authors' knowledge, the present study is the first to examine the association for veterans of the current Iraq and Afghanistan conflicts.

Given the time frame of the recent wars, the authors of the study did not look at heart attacks or other events, but examined risk factors for heart disease instead. PTSD and other mental disorders, such anxiety disorder, more than doubled the risk of tobacco use, for example, which is a well-known risk factor.

The study, by Dr. Beth E. Cohen and colleagues, from Veterans Affairs Medical Center, San Francisco, included more than 300,000 veterans who began using Veterans Affairs healthcare from October 7, 2001 to September 30, 2008.

Most - 88 percent - of the subjects were male and the average age was 31 years.

About a quarter had PTSD. Among those who did, about half also suffered from depression, and more than a quarter suffered from anxiety disorder. About a fifth abused alcohol.

Men with mental disorders other than PTSD were at increased risk for all of the heart disease risk factors studied, including tobacco use, high blood pressure, obesity, and diabetes. All of those risk factors were also elevated in men with PTSD, except diabetes.

In women, PTSD was significantly linked to all of the risk factors studied. Other mental disorders were tied to all of the risk factors except diabetes.

SOURCE: JAMA, August 5, 2009.

Afghanistan Medicine Iraq