Injured Veterans More Likely to Develop Cardiovascular Disease: Study

Pavankumar Kamat

November 29, 2021

British soldiers who sustained combat injuries during the conflict in Afghanistan have a higher risk of developing cardiovascular disease (CVD) compared with their uninjured counterparts, according to early findings from the ADVANCE study (Armed Services Trauma Rehabilitation Outcome Study) published in the journal  Heart .

Dr Christopher Boos, one of the principal investigators of ADVANCE said: "As a result of the Iraq and Afghanistan conflicts coming in rapid succession of each other, we have many veterans with combat injuries for which we don’t understand the long-term psychological and cardiovascular outcomes."

"It was important to undertake this study to better understand the long-term psychological and medical outcomes of these individuals."

Researchers analysed data from 1144 male military veterans in the UK who had served in Afghanistan (579 with combat injuries and 565 uninjured). Their average age at the time of baseline assessment was 34.1 years, the mean time from injury/deployment being 8.3 years. The injured and the uninjured groups were comparable in terms of smoking status, ethnicity, and family history of CVD.

The study found that 18.0% of injured veterans versus 11.8% of the uninjured veterans had metabolic syndrome (adjusted risk ratio, 1.46; P<0.0001). Additionally, the injured versus uninjured group had a higher prevalence of arterial stiffness assessed by the heart rate-adjusted central augmentation index (17.61% vs 15.23%; P<0.0001). The association of combat injuries with metabolic syndrome and arterial stiffness became more pronounced with worsening injury severity, independent of age, socioeconomic status, physical activity, ethnicity, and time from injury.

The authors concluded: "This has important potential implications for the future health of service personnel and others who sustain severe physical trauma."

The continued follow-up of this cohort will help determine if these findings translate into clinical events and whether targeted primary prevention strategies to the more severely injured might be indicated.

The ADVANCE Study is funded through the ADVANCE Charity, whose contributors include the Headley Court Charity (principal funder), HM Treasury (LIBOR Grant), Help for Heroes, Nuffield Trust for the Forces of the Crown, Forces in Mind Trust, National Lottery Community Fund, Blesma - The Limbless Veterans and the UK Ministry of Defence.

Boos CJ, Schofield S, Cullinan P, Dyball D, Fear NT, Bull AMJ, Pernet D, Bennett AN; ADVANCE study. Association between combat-related traumatic injury and cardiovascular risk. Heart. 2021 Nov 25 [Epub ahead of print]. doi: 10.1136/heartjnl-2021-320296. PMID: 34824088.

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