Key Takeaways
Extended Takeaways
- In this nationally representative sample of veterans aged 60 years and older, 72 veterans (weighted % =2.2%) had comorbid CVD+PTSD; this small subgroup still translates to approximately 230,000 older veterans nationwide, supporting case-finding in geriatric veteran care.
- Compared to controls, CVD+PTSD was independently associated with being a combat veteran (OR=1.99, 95% CI, 1.11–3.59), greater childhood adversity (OR=1.30, 95% CI, 1.15–1.48), more lifetime traumatic events (OR=1.04, 95% CI, 1.01–1.07), nicotine use disorder history (OR=1.89, 95% CI, 1.01–3.55), high blood pressure (OR=2.74, 95% CI, 1.31–5.77), and lower likelihood of being married or partnered (OR=0.32, 95% CI, 0.18–0.57).
- Relative to CVD only, the comorbid group showed particularly large excess psychiatric burden, with nearly 10-fold greater odds of GAD, nearly 8-fold greater odds of depression, and higher odds of current suicidal ideation and sleep disorder; adding PTSD to CVD should prompt broader psychiatric review rather than focusing only on cardiac management.
- Compared to PTSD only, veterans with CVD+PTSD were older (OR =1.05, 95% CI, 1.01–1.11) and more likely to have high blood pressure (OR= 4.39, 95% CI, 1.96–9.86), while also showing nearly 5-fold greater odds of kidney disease and more than 2.5-fold greater odds of sleep disorder, suggesting added medical complexity when cardiovascular illness is present.
- Functional differences were most pronounced in cognition and psychosocial functioning: compared with CVD only, veterans with CVD+PTSD had moderate deficits in cognitive functioning (d =0.66) and psychosocial difficulties (d=0.63), and compared with PTSD only they again showed moderate impairments in cognitive functioning (d= 0.50) and psychosocial difficulties (d=0.50).
- Suicide risk assessment should not be overlooked in this group: the article notes that nearly 1 in 5 veterans with CVD+PTSD reported SI, even though PTSD emerged as the strongest correlate of current SI and odds were not higher in the comorbid group than in PTSD only.
