This is an application for a K23 award for Dr. Beth Cohen, a general internist at the University of California, San Francisco who is conducting patient-oriented research to reduce cardiovascular disease (CVD) in patients with post-traumatic stress disorder (PTSD). PTSD is an increasingly common illness that causes substantial mental and physical disability. Patients with PTSD are at greatly increased risk for developing CVD, but the underlying mechanisms are not known. Dr. Cohen's goal is to determine how PTSD increases CVD risk and to translate these findings into interventions that will reduce CVD morbidity and mortality in the growing number of veterans and civilians living with PTSD. To accomplish this, Dr. Cohen will analyze 3 populations that vary by length of exposure to PTSD and stage of CVD. Using a database of over 200,000 veterans returning from Iraq and Afghanistan, Dr. Cohen will compare levels of established CVD risk factors and rates of incident CVD in those with and without PTSD (Aim 1). Dr. Cohen will also conduct a pilot prospective cohort study to examine established and novel CVD risk factors in a group of older veterans and civilians without known CVD (Aim 2). Finally, using an ongoing prospective cohort, she will conduct an ancillary study of 820 men and women with known CVD to determine which biological, behavioral, and psychosocial mechanisms link PTSD to recurrent CVD events (Aim 3). This research will provide preliminary data for an R01 to conduct a larger prospective cohort study to identify targets for future intervention studies. To accomplish these research goals, Dr. Cohen will pursue training in: (1) adapting administrative and healthcare data for patient-oriented research, (2) advanced longitudinal data analysis, (3) the design and conduct of prospective cohort studies, and (4) psychosocial and cardiovascular disease measures. Dr. Cohen has assembled an outstanding multidisciplinary mentorship team, comprised of a primary mentor Dr. Mary Whooley, an expert CVD epidemiology, Dr. Charles Marmar, a psychiatrist who is an expert in PTSD epidemiology and treatment, and Dr. Eric Vittinghoff, an expert in study design and biostatistical analysis. In addition, Dr. Cohen has advisors from cardiology (Dr. Nelson Schiller), internal medicine (Dr. Karen Seal), and the social sciences (Dr. Judith Moskowitz). This dedicated mentorship team, combined with a rigorous, supportive research environment, will ensure Dr. Cohen develops into a successful independent investigator.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Mentored Patient-Oriented Research Career Development Award (K23)
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Study Section
Special Emphasis Panel (ZHL1-CSR-R (O1))
Program Officer
Kaufmann, Peter G
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Arenson, Melanie B; Whooley, Mary A; Neylan, Thomas C et al. (2018) Posttraumatic stress disorder, depression, and suicidal ideation in veterans: Results from the mind your heart study. Psychiatry Res 265:224-230
O'Donovan, Aoife; Ahmadian, Ashkan J; Neylan, Thomas C et al. (2017) Current posttraumatic stress disorder and exaggerated threat sensitivity associated with elevated inflammation in the Mind Your Heart Study. Brain Behav Immun 60:198-205
Kalapatapu, Raj K; Dannenbaum, Tatiana P; Harbison, John D et al. (2017) Does trauma exposure predict prescription drug problems beyond the contribution of post-traumatic stress disorder and depression? An analysis of the Mind Your Heart cohort study. J Addict Dis 36:183-192
Beristianos, Matthew H; Yaffe, Kristine; Cohen, Beth et al. (2016) PTSD and Risk of Incident Cardiovascular Disease in Aging Veterans. Am J Geriatr Psychiatry 24:192-200
Grenon, S Marlene; Owens, Christopher D; Alley, Hugh et al. (2016) Posttraumatic Stress Disorder Is Associated With Worse Endothelial Function Among Veterans. J Am Heart Assoc 5:e003010
Wingenfeld, Katja; Whooley, Mary A; Neylan, Thomas C et al. (2015) Effect of current and lifetime posttraumatic stress disorder on 24-h urinary catecholamines and cortisol: results from the Mind Your Heart Study. Psychoneuroendocrinology 52:83-91
Cohen, Beth E; Edmondson, Donald; Kronish, Ian M (2015) State of the Art Review: Depression, Stress, Anxiety, and Cardiovascular Disease. Am J Hypertens 28:1295-302
Smith, Brian N; Tyzik, Anna L; Neylan, Thomas C et al. (2015) PTSD and obesity in younger and older veterans: Results from the mind your heart study. Psychiatry Res 229:895-900
O'Donovan, Aoife; Cohen, Beth E; Seal, Karen H et al. (2015) Elevated risk for autoimmune disorders in iraq and afghanistan veterans with posttraumatic stress disorder. Biol Psychiatry 77:365-74
Cohen, Beth E; Shi, Ying; Neylan, Thomas C et al. (2015) Antipsychotic prescriptions in Iraq and Afghanistan veterans with posttraumatic stress disorder in Department of Veterans Affairs healthcare, 2007-2012. J Clin Psychiatry 76:406-12

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