Megan R Gerber1,2, Matthew W King3,4, Katherine M Iverson3,4, Suzanne L Pineles3,4, Sally G Haskell5,6. 1. 1 Women's Health, VA Boston Healthcare System , Jamaica Plain, Massachusetts. 2. 2 Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine , Boston, Massachusetts. 3. 3 National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Jamaica Plain, Massachusetts. 4. 4 Department of Psychiatry, Boston University School of Medicine , Boston, Massachusetts. 5. 5 Section of General Internal Medicine, Department of Medicine, VA Connecticut Healthcare System , West Haven, Connecticut. 6. 6 Section of General Internal Medicine, Department of Medicine, Yale University School of Medicine , New Haven, Connecticut.
Abstract
BACKGROUND: The women Veteran population accessing Veterans Health Administration (VA) care has grown rapidly. Women Veterans exhibit high rates of mental health conditions that increase coronary artery disease (CAD) risk; however, the relationship between specific conditions and increasing mental health burden to CAD in this population is unknown. MATERIALS AND METHODS: Using VA National Patient Care Data for 2009, we identified women Veterans over 45 (N = 157,195). Logistic regression models examined different mental health diagnoses and increasing mental health burden (number of diagnostic clusters) as predictors of CAD. RESULTS: CAD prevalence was 4.16%, and 36% of women Veterans were current smokers. Depression exhibited the strongest association with CAD (odds ratio [OR] 1.60, 95% confidence interval [CI] [1.50-1.71]), similar to that of current smoking (OR 1.68 [1.58-1.78]). Controlling for demographic variables, smoking, diabetes, and obesity, each additional mental health diagnosis increased the odds of CAD by 44%. CONCLUSIONS: Women Veterans over age 45 accessing VA care exhibited a high degree of mental health burden, which is associated with elevated odds of CAD; those with depression alone had 60% higher odds of CAD. For women Veterans using VA, mental health diagnoses may act as CAD risk factors that are potentially modifiable. Novel interventions in primary care and mental health are needed to address heart disease in this growing and aging population.
BACKGROUND: The women Veteran population accessing Veterans Health Administration (VA) care has grown rapidly. Women Veterans exhibit high rates of mental health conditions that increase coronary artery disease (CAD) risk; however, the relationship between specific conditions and increasing mental health burden to CAD in this population is unknown. MATERIALS AND METHODS: Using VA National Patient Care Data for 2009, we identified women Veterans over 45 (N = 157,195). Logistic regression models examined different mental health diagnoses and increasing mental health burden (number of diagnostic clusters) as predictors of CAD. RESULTS: CAD prevalence was 4.16%, and 36% of women Veterans were current smokers. Depression exhibited the strongest association with CAD (odds ratio [OR] 1.60, 95% confidence interval [CI] [1.50-1.71]), similar to that of current smoking (OR 1.68 [1.58-1.78]). Controlling for demographic variables, smoking, diabetes, and obesity, each additional mental health diagnosis increased the odds of CAD by 44%. CONCLUSIONS:Women Veterans over age 45 accessing VA care exhibited a high degree of mental health burden, which is associated with elevated odds of CAD; those with depression alone had 60% higher odds of CAD. For women Veterans using VA, mental health diagnoses may act as CAD risk factors that are potentially modifiable. Novel interventions in primary care and mental health are needed to address heart disease in this growing and aging population.
Entities:
Keywords:
aging; anxiety; coronary artery disease; depression; women Veterans
Authors: Natasha Petry; Roxana Lupu; Ahmed Gohar; Eric A Larson; Carmen Peterson; Vanessa Williams; Jing Zhao; Russell A Wilke; Lindsay J Hines Journal: Pharmacogenomics Date: 2019-04-15 Impact factor: 2.533
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