Mu-Hong Chen1, Tai-Long Pan1, Cheng-Ta Li1, Wei-Chen Lin1, Ying-Sheue Chen1, Ying-Chiao Lee1, Shih-Jen Tsai1, Ju-Wei Hsu1, Kai-Lin Huang1, Chia-Fen Tsai1, Wen-Han Chang1, Tzeng-Ji Chen1, Tung-Ping Su1, Ya-Mei Bai1. 1. Mu-Hong Chen, MD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei; Tai-Long Pan, PhD, School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, and Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, and Liver Research Center, Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan; Cheng-Ta Li, MD, PhD, Wei-Chen Lin, MD, Ying-Sheue Chen, MD, Ying-Chiao Lee, MD, Shih-Jen Tsai, MD, Ju-Wei Hsu, MD, Kai-Lin Huang, MD, Chia-Fen Tsai, MD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei; Wen-Han Chang, MSc, Department of Psychiatry, Taipei Veterans General Hospital, Taipei; Tzeng-Ji Chen, MD, PhD, Department of Family Medicine, Taipei Veterans General Hospital, Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei; Tung-Ping Su, MD, Ya-Mei Bai, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
Abstract
BACKGROUND: Previous evidence has shown positive associations between post-traumatic stress disorder (PTSD) and hypertension, dyslipidaemia and diabetes mellitus, which are all risk factors for stroke, but the role of PTSD in the subsequent development of stroke is still unknown. AIMS: To investigate the temporal association between PTSD and the development of stroke. METHOD: Identified from the Taiwan National Health Insurance Research Database, 5217 individuals aged ≥18 years, with PTSD but with no history of stroke, and 20 868 age- and gender-matched controls were enrolled between 2002 and 2009, and followed up until the end of 2011 to identify the development of stroke. RESULTS: Individuals with PTSD had an increased risk of developing any stroke (hazard ratio (HR) 3.37, 95% CI 2.44-4.67) and ischaemic stroke (HR = 3.47, 95% CI 2.23-5.39) after adjusting for demographic data and medical comorbidities. Sensitivity tests showed consistent findings (any stroke HR = 3.02, 95% CI 2.13-4.28; ischaemic stroke HR = 2.89, 95% CI 1.79-4.66) after excluding the first year of observation. CONCLUSIONS: Individuals with PTSD have an increased risk of developing any stroke and ischaemic stroke. Further studies are required to investigate the underlying mechanisms. Royal College of Psychiatrists.
BACKGROUND: Previous evidence has shown positive associations between post-traumatic stress disorder (PTSD) and hypertension, dyslipidaemia and diabetes mellitus, which are all risk factors for stroke, but the role of PTSD in the subsequent development of stroke is still unknown. AIMS: To investigate the temporal association between PTSD and the development of stroke. METHOD: Identified from the Taiwan National Health Insurance Research Database, 5217 individuals aged ≥18 years, with PTSD but with no history of stroke, and 20 868 age- and gender-matched controls were enrolled between 2002 and 2009, and followed up until the end of 2011 to identify the development of stroke. RESULTS: Individuals with PTSD had an increased risk of developing any stroke (hazard ratio (HR) 3.37, 95% CI 2.44-4.67) and ischaemic stroke (HR = 3.47, 95% CI 2.23-5.39) after adjusting for demographic data and medical comorbidities. Sensitivity tests showed consistent findings (any stroke HR = 3.02, 95% CI 2.13-4.28; ischaemic stroke HR = 2.89, 95% CI 1.79-4.66) after excluding the first year of observation. CONCLUSIONS: Individuals with PTSD have an increased risk of developing any stroke and ischaemic stroke. Further studies are required to investigate the underlying mechanisms. Royal College of Psychiatrists.
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