The association between PTSD and cardiovascular disease and its risk factors in male veterans of the Iraq/Afghanistan conflicts:a systematic review
In: Dyball , D , Evans , S C M , Boos , C J , Stevelink , S & Fear , N T 2019 , ' The association between PTSD and cardiovascular disease and its risk factors in male veterans of the Iraq/Afghanistan conflicts : a systematic review ' , International Review of Psychiatry , vol. 31 , no. 1 , pp. 34-48 . https://doi.org/10.1080/09540261.2019.1580686
Military personnel with Post-Traumatic Stress Disorder (PTSD) can experience high levels of mental and physical health comorbidity, potentially indicating a high level of functional impairment that can impact on both military readiness and later ill-health. There is strong evidence to implicate PTSD as a contributory factor to Cardiovascular Disease (CVD) among serving personnel and veterans. This systematic review focusses on the association between PTSD and cardiovascular disease/risk factors in male, military serving and ex-serving personnel who served in the Iraq/Afghanistan conflicts. PUBMED, MEDLINE, PILOTS, EMBASE, PSYCINFO and PSYCARTICLES were searched using PRISMA guidelines. Three hundred and forty-three records were identified, of which twenty articles were selected. PTSD was positively associated with the development of CVD, specifically circulatory diseases, including hypertension. PTSD was also positively associated with the following risk factors: elevated heart rate tobacco use, dyslipidaemia and obesity. Conflicting data is presented regarding heart rate variability and inflammatory markers. Future studies would benefit from a standardised methodological approach to investigating PTSD and physical health manifestations. It is suggested that clinicians offer health advice for CVD at an earlier age for ex-/serving personnel with PTSD.