Combined effect of posttraumatic stress disorder and prescription opioid use on risk of cardiovascular disease

被引:6
|
作者
Scherrer, Jeffrey F. [1 ,2 ]
Salas, Joanne [1 ,2 ]
Lustman, Patrick [3 ,4 ]
Tuerk, Peter [5 ]
Gebauer, Sarah [1 ,2 ]
Norman, Sonya B. [6 ,7 ]
Schneider, F. David [8 ]
Chard, Kathleen M. [9 ,10 ]
van den Berk-Clark, Carissa [1 ]
Cohen, Beth E. [11 ,12 ]
Schnurr, Paula P. [13 ,14 ]
机构
[1] St Louis Univ, Dept Family & Community Med, Sch Med, St Louis, MO 63104 USA
[2] Harry S Truman Mem Vet Hosp, Columbia, MO USA
[3] Washington Univ, Sch Med, Dept Psychiat, St Louis, MO 63110 USA
[4] VA St Louis Healthcare Syst, Bell St Clin Opioid Addict Treatment Programs, St Louis, MO USA
[5] Univ Virginia, Dept Human Serv, Sheila C Johnson Ctr Clin Serv, Charlottesville, VA USA
[6] Univ Calif San Diego, Natl Ctr PTSD, La Jolla, CA 92093 USA
[7] Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA
[8] Univ Texas Southwestern Med Ctr Dallas, Dept Family & Community Med, Dallas, TX 75390 USA
[9] Trauma Recovery Ctr Cincinnati VAMC, Cincinnati, OH USA
[10] Univ Cincinnati, Dept Psychiat & Behav Neurosci, Cincinnati, OH 45221 USA
[11] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA
[12] San Francisco VA Med Ctr, San Francisco, CA USA
[13] Geisel Sch Med Dartmouth, Natl Ctr PTSD, Hanover, NH USA
[14] Geisel Sch Med Dartmouth, Dept Psychiat, Hanover, NH USA
关键词
PTSD; opioids; cardiovascular disease; epidemiology; medical records; cohort; PROPENSITY SCORE METHODS; CORONARY-HEART-DISEASE; NONCANCER PAIN; OLDER-ADULTS; VETERANS; VALIDATION; DEPRESSION; SYMPTOMS; DURATION; VALIDITY;
D O I
10.1177/2047487319850717
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim Prescription opioid analgesic use (OAU) is associated with increased risk of cardiovascular disease (CVD). OAU is more common in patients with than without posttraumatic stress disorder (PTSD), and PTSD is associated with higher CVD risk. We determined whether PTSD and OAU have an additive or multiplicative association with incident CVD. Methods and results Veterans Health Affairs patient medical record data from 2008 to 2015 was used to identify 2861 patients 30-70 years of age, free of cancer, CVD and OAU for 12 months before index date. We defined a four-level exposure variable: 1) no PTSD/no OAU, 2) OAU alone, 3) PTSD alone and 4) PTSD+OAU. Cox proportional hazard models estimated the association between the exposure variable and incident CVD. The mean age was 49.0 (+/- 11.0), 85.7% were male and 58.3% were White, 34.4% had no PTSD/no OAU, 32.9% had PTSD alone, 10.6% had OAU alone, and 22.1% had PTSD+OAU. Compared with patients with no PTSD/no OAU, those with PTSD alone were not at increased risk of incident CVD (hazard ratio = 0.82; 95% confidence interval (CI): 0.63-1.17); however, OAU alone and PTSD+OAU were both significantly associated with incident CVD (hazard ratio = 1.99; 95% CI:1.36-2.92 and hazard ratio = 2.20; 95% CI: 1.61-3.02). There was no significant additive or multiplicative PTSD and OAU association with incident CVD. Conclusion OAU is associated with nearly a two-fold increased risk of CVD in patients with and without PTSD. Despite no additive or multiplicative interaction effects, the high prevalence of OAU in PTSD may represent a novel contributor to the elevated CVD burden among patients with PTSD.
引用
收藏
页码:1412 / 1422
页数:11
相关论文
共 50 条
  • [1] Comorbid Conditions Explain the Association Between Posttraumatic Stress Disorder and Incident Cardiovascular Disease
    Scherrer, Jeffrey F.
    Salas, Joanne
    Cohen, Beth E.
    Schnurr, Paula P.
    Schneider, F. David
    Chard, Kathleen M.
    Tuerk, Peter
    Friedman, Matthew J.
    Norman, Sonya B.
    van den Berk-Clark, Carissa
    Lustman, Patrick J.
    JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2019, 8 (04):
  • [2] Posttraumatic Stress Disorder as a Consequence of Acute Cardiovascular Disease
    Princip, Mary
    Ledermann, Katharina
    von Kanel, Roland
    CURRENT CARDIOLOGY REPORTS, 2023, 25 (06) : 455 - 465
  • [3] Heightened healthcare utilization & risk of mental disorders among Veterans with comorbid opioid use disorder & posttraumatic stress disorder
    Mahoney, Colin T.
    Moshier, Samantha J.
    Keane, Terence M.
    Marx, Brian P.
    ADDICTIVE BEHAVIORS, 2021, 112
  • [4] Trauma and Posttraumatic Stress Disorder Emerging Risk Factors for Cardiovascular Disease in Women?
    Lewis, Tene T.
    CIRCULATION, 2015, 132 (04) : 227 - 229
  • [5] Posttraumatic Stress Disorder and Cardiovascular Disease
    Edmondson, Donald
    Cohen, Beth E.
    PROGRESS IN CARDIOVASCULAR DISEASES, 2013, 55 (06) : 548 - 556
  • [6] CARDIOVASCULAR DISEASE RISK FACTORS IN PATIENTS WITH POSTTRAUMATIC STRESS DISORDER (PTSD): A NARRATIVE REVIEW
    Sagud, Marina
    Jaksic, Nenad
    Vuksan-Cusa, Bjanka
    Loncar, Mladen
    Loncar, Ivana
    Peles, Alma Mihaljevic
    Milicic, Davor
    Jakovljevic, Miro
    PSYCHIATRIA DANUBINA, 2017, 29 (04) : 421 - 430
  • [7] Posttraumatic Stress and Cardiovascular Disease Risk
    Kibler, Jeffrey L.
    JOURNAL OF TRAUMA & DISSOCIATION, 2009, 10 (02) : 135 - 150
  • [8] Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial
    Watkins, Lana L.
    LoSavio, Stefanie T.
    Calhoun, Patrick
    Resick, Patricia A.
    Sherwood, Andrew
    Coffman, Cynthia J.
    Kirby, Angela C.
    Beaver, Tiffany A.
    Dennis, Michelle F.
    Beckham, Jean C.
    JOURNAL OF PSYCHOSOMATIC RESEARCH, 2023, 170
  • [9] Posttraumatic stress disorder and responses to couple conflict: Implications for cardiovascular risk
    Caska, Catherine M.
    Smith, Timothy W.
    Renshaw, Keith D.
    Allen, Steven N.
    Uchino, Bert N.
    Birmingham, Wendy
    Carlisle, McKenzie
    HEALTH PSYCHOLOGY, 2014, 33 (11) : 1273 - 1280
  • [10] Co-Occurrence of Posttraumatic Stress Disorder and Cardiovascular Disease Among Ethnic/Racial Groups in the United States
    Vidal, Carmen
    Polo, Ruth
    Alvarez, Kiara
    Falgas-Bague, Irene
    Wang, Ye
    Le Cook, Benjamin
    Alegria, Margarita
    PSYCHOSOMATIC MEDICINE, 2018, 80 (07): : 680 - 688