Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women.
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Abstract | BACKGROUND: Trauma exposure and posttraumatic stress disorder (PTSD) have been linked to myocardial infarction and stroke in women, with biological and behavioral mechanisms implicated in underlying risk. The third most common cardiovascular illness, venous thromboembolism (VTE), is a specific health risk for women. Given previous associations with other cardiovascular diseases, we hypothesized that high levels of trauma and PTSD symptoms would be associated with higher risk of incident VTE in younger and middle-aged women. METHODS AND RESULTS: We used proportional hazards models to estimate hazard ratios (HRs) and 95% CIs for new-onset VTE (960 events) over 22 years in 49 296 women in the Nurses' Health Study II. Compared to no trauma exposure, both trauma exposure and PTSD symptoms were significantly associated with increased risk of developing VTE, adjusting for demographics, family history, and childhood adiposity. Women with the most PTSD symptoms exhibited the greatest risk elevation: trauma/6 to 7 symptoms: HR=2.42 (95% CI, 1.83-3.20); trauma/4 to 5 symptoms: HR=2.00 (95% CI, 1.55-2.59); trauma/1 to 3 symptoms: HR=1.44 (95% CI, 1.12-1.84); trauma/no symptoms: HR=1.72 (95% CI, 1.43-2.08). Results were similar, although attenuated, when adjusting for VTE-relevant medications, medical conditions, and health behaviors. CONCLUSIONS: Women with the highest PTSD symptom levels had nearly a 2-fold increased risk of VTE compared to women without trauma exposure in fully adjusted models. Trauma exposure alone was also associated with elevated VTE risk. Trauma and PTSD symptoms may be associated with a hypercoagulable state. Treatment providers should be aware that women with trauma exposure and PTSD symptoms may be vulnerable to VTE. |
Year of Publication | 2016
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Journal | J Am Heart Assoc
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Volume | 5
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Issue | 5
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Date Published | 2016 May 12
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ISSN | 2047-9980
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URL | |
DOI | 10.1161/JAHA.116.003197
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PubMed ID | 27172912
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PubMed Central ID | PMC4889189
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Links | |
Grant list | UM1 CA176726 / CA / NCI NIH HHS / United States
R01 HL116854 / HL / NHLBI NIH HHS / United States
R01 MH101269 / MH / NIMH NIH HHS / United States
T32 MH017119 / MH / NIMH NIH HHS / United States
K01 HL130650 / HL / NHLBI NIH HHS / United States
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