This is a first resubmission of Assignment Number 1 R21 HL080422-01 titled """"""""Combat Stress and Cardiovascular Risk Among Aging Men"""""""". Combat trauma is a stressor associated with relatively high rates of psychological morbidity, negative health behaviors. Despite links between stress and cardiovascular disease (CVD), relatively few studies have investigated the association between combat stress and CVD, and these studies have been inconclusive and mostly based on self-reported outcomes. We propose to examine the association between combat stress and CVD (predicted risk of stroke and CHD, diabetes, cholesterol, carotid atherosclerosis, SBP) using extant data from more than 5,300 black and white middle- aged men from the Atherosclerosis Risk in Communities (ARIC) Study who were queried about military service during annual follow-up occurring after the baseline exam. Eras of military service spanned from World War II through the Vietnam War. The men will be divided into three groups based on their military service: no history of military service, history of service without combat, and history of service with combat. Established CHD and stroke risk prediction equations will be formulated using CVD risk factor data obtained from standardized measurements obtained at baseline. The extent to which differences (if extant) in CVD risk factors and predicted risk among exposure groups are explained by variations in psychosocial characteristics (e.g. social support, vital exhaustion, trait anger), socioeconomic status, and behavioral risk profiles (e.g., smoking, obesity, physical activity) will be examined. Variations in the combat stress - CVD association by era of service will also be investigated. For men who died prior to data collection on military service, veteran's status will be obtained from death certificates to assess differences in mortality by veterans status and to perform sensitivity analyses to estimate potential effects of survivorship bias. Study results will contribute to the limited extant literature regarding military service and CVD. Furthermore, they may provide data useful in planning public health intervention programs which target active service and veteran populations. ? ?
| Johnson, Anna M; Rose, Kathryn M; Elder Jr, Glen H et al. (2010) Military combat and risk of coronary heart disease and ischemic stroke in aging men: The Atherosclerosis Risk in Communities (ARIC) study. Ann Epidemiol 20:143-50 |
| Williams, Janice E; Johnson, Anna M; Heiss, Gerardo et al. (2010) Association between exposure to combat-related stress and psychological health in aging men: the Atherosclerosis Risk in Communities (ARIC) Study. J Trauma Stress 23:358-66 |
| Johnson, Anna M; Rose, Kathryn M; Elder Jr, Glen H et al. (2010) Military combat and burden of subclinical atherosclerosis in middle aged men: the ARIC study. Prev Med 50:277-81 |
