Significant Risk Factor
In a 13-year span, 766 veterans were diagnosed with TIA and 1,877 with stroke and 28.6% with PTSD. On an unadjusted basis, PTSD more than doubled the risk of TIA. That made it a more significant risk factor than diabetes or sleep apnea.
PTSD increased the risk of stroke by 62%, putting it ahead of known risk factors such as obesity and smoking. The researchers found that veterans with PTSD were more likely to exhibit behaviors such as smoking and a sedentary lifestyle, which are also associated with greater risk of stroke.
After adjustment for other stroke risk factors, non-PTSD psychiatric disorders, and substance use disorder, veterans with PTSD had a 61% increased risk of TIA and 36% greater risk of stroke than veterans without PTSD.
PTSD increased the risk of stroke 37% more in men than in women, though sex did not affect the association with TIA. The lack of effect modification by sex for TIA could be related to the low rate of TIA among women in the study, Rosman explained.
The higher degree of association between PTSD and stroke in men compared to women has been seen in other studies. “The reasons for these differences cannot be elucidated from this study, but age-related differences in stroke risk may explain our results, since men are more likely to develop stroke at an earlier age than women,” she noted. Future studies should examine whether sex continues to affect the association of PTSD and other risk markers with stroke as the population ages, Rosman said.
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