Key result
PTSD linked to ~24% higher risk of incident composite CVD vs. matched controls.
Why the study?
Women veterans are an understudied population with a high burden of psychiatric conditions and cardiovascular disease, prompting evaluation of the association between PTSD and incident cardiovascular outcomes.
Does posttraumatic stress disorder increase the risk of incident cardiovascular disease in women veterans?
Cohort (n=202,896)
Yes
Does posttraumatic stress disorder increase the risk of incident cardiovascular disease in women veterans?
PTSD is a significant risk factor for a broad spectrum of incident cardiovascular diseases in relatively young women veterans, highlighting the need for earlier CVD risk assessment in this population.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We have a rising number of women veterans, and a large proportion of them—nearly 1 in 5—have PTSD. These women are at high risk for heart disease, and what's more, they appear to be getting it at a younger age—even in their 40s. This is not something we can ignore.”
“While the initial studies showing this association were cross-sectional, recent retrospective longitudinal studies provided similar results.”
“The majority of people will undergo a traumatic event at least once in their lifetime. Our goal is to improve the lives of people who experience trauma.”
Supports earlier CVD risk assessment in women veterans with PTSD; extends prior associations but leaves causality and intervention effects open.
Background Women veterans are a growing—yet understudied—population with a high psychiatric and cardiovascular disease (CVD) risk burden. This study evaluated the association of posttraumatic stress disorder (PTSD) with a wide range of incident CVD outcomes in a large, nationally representative cohort of women veterans. Methods In this retrospective longitudinal study, Veterans Health Administration (VHA) electronic health records were used to identify women veterans aged ≥18 years receiving care from 1/1/2000 to 12/31/2019 in the USA. Women with prior CVD at baseline were excluded. Participants with PTSD ( n = 101,448) were matched 1:1 to women without PTSD on demographic, clinical, and healthcare utilization factors. Diagnoses were based on International Classification of Diseases codes. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of PTSD with an incident CVD composite (IHD, stroke/transient ischemic attack [TIA], heart failure [HF], atrial fibrillation, peripheral arterial disease, pulmonary hypertension [PHTN], venous thromboembolism [VTE], and aortic valve stenosis [AS]), and each component outcome. Findings The analytic sample comprised 202,896 women veterans (mean age=39.1 years). Over approximately 6 years of follow-up, PTSD was associated with a greater rate of developing the CVD composite (HR = 1.24, 95% CI: 1.20–1.28). PTSD was also associated with greater incidence of IHD (HR = 1.30, 95% CI: 1.23–1.37), stroke/TIA (HR = 1.29, 95% CI: 1.21–1.38), HF (HR = 1.10, 95% CI: 1.02–1.18), PHTN (HR = 1.17, 95% CI: 1.02–1.35), VTE (HR = 1.34, 95% CI: 1.23–1.45), and AS (HR = 1.23, 95% CI: 1.03–1.46). Particularly strong associations were observed in women <40 years and in American Indian/Alaska Native and Hispanic/Latina women. Interpretation PTSD is associated with a broad spectrum of CVD outcomes in women veterans. Results also indicate associations of PTSD with PHTN and AS, novel outcomes in the PTSD-CVD literature—including in women veterans. Targeted studies are needed to better understand underlying mechanisms. Funding This research was funded by a grant from the Department of Defense Office of Congressionally Directed Medical Research Programs.The funder had no role in the study design, data collection, analysis, interpretation, or writing of the manuscript.
No takes yet. Share an insight, caveat, or question.
Ebrahimi et al. (2026) conducted a cohort in Women veterans without prior cardiovascular disease (n=202,896). Posttraumatic stress disorder (PTSD) vs. Matched women veterans without PTSD was evaluated on Incident CVD composite (IHD, stroke/TIA, HF, AF, PAD, PHTN, VTE, and AS) (HR 1.24, 95% CI 1.20-1.28, p=<0.001). Posttraumatic stress disorder was associated with a 24% increased risk of developing an incident cardiovascular disease composite compared to matched controls without PTSD (HR 1.24).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: