i ASSOCIATION BETWEEN EXPOSURE TO COMBAT AND BURDEN OF CORONARY HEART DISEASE, ISCHEMIC STROKE AND SUBCLINICAL ATHEROSCLEROSIS IN AGING MEN: THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY

Studies of the long-term cardiovascular consequences of combat stress are few and inconclusive. The association between remote exposure to combat and subclinical atherosclerosis was assessed among 5,347 men in the Atherosclerosis Risk in Communities study. Coronary artery plaque and carotid intima-media thickness (CIMT) were compared between non-veterans and veterans with and without one or more self-reported combat exposures. Cardiovascular measurements were taken an average of 36 years after entry into military service. Combat veterans (n=1178) and non-combat veterans (n=2127) tended to be older, white and of higher socioeconomic status than non-veterans (n=2042). Veterans were more likely to be current drinkers and heavy smokers but less likely to be current smokers and physically inactive. Combat veterans had the highest average blood pressure and total cholesterol and were most likely to have coronary disease. Compared to non-veterans, combat veterans (Risk Ratio (RR): 1.19; 95% Confidence Interval (95% CI): 1.11, 1.28) and non-combat veterans (RR: 1.08; 95% CI: 1.01, 1.15) had a higher risk of carotid plaque, and both combat veterans (Risk Difference (RD): 57.2μm; 95% CI: 45.1, 69.2) and non-combat