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Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme

Epidemiology and psychiatric sciences, 2024-02, Vol.33, p.e5-e5, Article e5 [Peer Reviewed Journal]

The Author(s), 2024. Published by Cambridge University Press. ;The Author(s), 2024. Published by Cambridge University Press. This work is licensed under the Creative Commons Attribution License This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2024 2024 The Author(s) ;ISSN: 2045-7960 ;EISSN: 2045-7979 ;DOI: 10.1017/S2045796024000052 ;PMID: 38314538

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Title:
Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme
Author: Mesa-Vieira, Cristina ; Didden, Christiane ; Schomaker, Michael ; Mouton, Johannes P. ; Folb, Naomi ; van den Heuvel, Leigh L. ; Gastaldon, Chiara ; Cornell, Morna ; Tlali, Mpho ; Kassanjee, Reshma ; Franco, Oscar H. ; Seedat, Soraya ; Haas, Andreas D.
Subjects: Age groups ; Angina pectoris ; Antipsychotics ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cholesterol ; Cohort analysis ; Cohort Studies ; depression ; Depressive Disorder, Major - epidemiology ; Diabetes ; Domestic violence ; Drug use ; epidemiology ; Female ; Females ; Health insurance ; health outcomes ; Heart attacks ; Hospitalization ; Hospitals ; Humans ; Hypertension ; Insurance ; Insurance coverage ; Longitudinal studies ; Male ; Males ; Mental depression ; Metabolic disorders ; Original ; Original Article ; Post traumatic stress disorder ; Psychosis ; Psychotropic drugs ; PTSD ; Risk Factors ; Sex crimes ; Sleep disorders ; South Africa - epidemiology ; Stress Disorders, Post-Traumatic - diagnosis ; Stress Disorders, Post-Traumatic - epidemiology ; Stroke ; Substance abuse ; Substance use disorder ; Survival analysis ; Trauma ; Veterans
Is Part Of: Epidemiology and psychiatric sciences, 2024-02, Vol.33, p.e5-e5, Article e5
Description: Prior research, largely focused on US male veterans, indicates an increased risk of cardiovascular disease among individuals with post-traumatic stress disorder (PTSD). Data from other settings and populations are scarce. The objective of this study is to examine PTSD as a risk factor for incident major adverse cardiovascular events (MACEs) in South Africa. We analysed reimbursement claims (2011-2020) of a cohort of South African medical insurance scheme beneficiaries aged 18 years or older. We calculated adjusted hazard ratios (aHRs) for associations between PTSD and MACEs using Cox proportional hazard models and calculated the effect of PTSD on MACEs using longitudinal targeted maximum likelihood estimation. We followed 1,009,113 beneficiaries over a median of 3.0 years (IQR 1.1-6.0). During follow-up, 12,662 (1.3%) persons were diagnosed with PTSD and 39,255 (3.9%) had a MACE. After adjustment for sex, HIV status, age, population group, substance use disorders, psychotic disorders, major depressive disorder, sleep disorders and the use of antipsychotic medication, PTSD was associated with a 16% increase in the risk of MACEs (aHR 1.16, 95% confidence interval (CI) 1.05-1.28). The risk ratio for the effect of PTSD on MACEs decreased from 1.59 (95% CI 1.49-1.68) after 1 year of follow-up to 1.14 (95% CI 1.11-1.16) after 8 years of follow-up. Our study provides empirical support for an increased risk of MACEs in males and females with PTSD from a general population sample in South Africa. These findings highlight the importance of monitoring cardiovascular risk among individuals diagnosed with PTSD.
Publisher: Cambridge, UK: Cambridge University Press
Language: English;Italian
Identifier: ISSN: 2045-7960
EISSN: 2045-7979
DOI: 10.1017/S2045796024000052
PMID: 38314538
Source: ProQuest One Psychology
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Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme

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