Key result
Veteran status linked to a trend toward higher serious psychological distress in at-risk cardiovascular patients.
Why the study?
To inform disease-care models by assessing physical and psychological functioning in veterans with, or at high risk of, heart disease.
Is military veteran status associated with worse physical and psychological functioning in patients with or at high risk of heart disease?
Cross-Sectional (n=28,314)
Yes
Is military veteran status associated with worse physical and psychological functioning in patients with or at high risk of heart disease?
Effect estimate: OR 1.36 (95% CI 0.99-1.86)
Veterans with or at high risk of heart disease experience similar physical impairments but potentially higher psychological distress compared to nonveterans, highlighting a need for multidisciplinary team-based care.
May warrant distress screening in veterans with heart disease; leaves open causality and needs prospective validation.
Introduction: The Veterans Health Administration (VHA) provides multidisciplinary team-based care with peer-to-peer support for diabetes and obesity, but not for most heart diseases. Objective: To inform disease-care models, assess physical and psychological functioning in veterans with, or at high risk of, heart disease. Methods: Retrospective, cross-sectional cohort analysis of data from the National Survey on Drug Use and Health, 2015-2019, based on standard measures of functioning: self-rated health, serious psychological distress, and high-risk substance use. Cohorts were veterans with respondent-reported heart disease, or at high risk of cardiovascular disease based on age/comorbidity combinations (HD/risk); nonveterans with HD/risk; and veterans without HD/risk. Ordinal logistic regression models adjusted for demographics, social determinants of health, and chronic conditions. A priori alpha was set to 0.01 because of large sample size (N = 28,314). Results: Among those with HD/risk, veterans (n = 3,483) and nonveterans (n = 16,438) had similar physical impairments, but distress trended higher among veterans (adjusted odds ratio = 1.36, 99% confidence interval [CI] = 0.99-1.86). Among those with comorbid HD/risk and behavioral health problems, regression-adjusted treatment rates were similar for veterans and nonveterans with psychological symptoms (55.9% vs. 55.2%, respectively, P = 0.531) or high-risk substance use (18.7% vs. 19.4%, P = .547); veterans were more likely to receive outpatient mental health treatment (36.1% [CI = 34.4%-37.8%] vs. 28.9% [CI = 28.2%-29.6%]). Conclusion: An upward trend in distress among veterans compared with nonveterans with HD/risk was not explained by differences in behavioral health treatment utilization. Further research should test multidisciplinary team-based care for veterans with HD/risk, similar to that used for other chronic diseases.
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Early et al. (2022) conducted a cross-sectional in Heart disease or high risk of cardiovascular disease (n=28,314). Veteran status vs. Nonveteran status was evaluated on Serious psychological distress (OR 1.36, 95% CI 0.99-1.86). Among individuals with or at high risk for heart disease, veteran status was associated with a trend toward higher serious psychological distress compared to nonveterans (OR 1.36; 99% CI 0.99-1.86).
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