Military combat and burden of subclinical atherosclerosis in middle aged men: the ARIC study.

Abstract

Studies of the cardiovascular consequences of combat stress are few and inconclusive. The association between combat exposure and subclinical atherosclerosis at Atherosclerosis Risk in Communities (ARIC) Study visits 1 (1987-1989) and 2 (1990-1992) was assessed among 5347 men from four U.S. communities. Measured an average of 36 years after military entry, carotid intima-media thickness (CIMT) and carotid plaque among non-combat veterans (n=2127) were compared with non-veterans (n=2042) and veterans reporting combat experience (n=1178). Compared to non-combat veterans, non-veterans (risk difference (RD): 10.61; 95% confidence interval (CI): 0.81, 20.41) and combat veterans (RD: 12.79; 95% CI: 0.72, 24.86) had higher age-adjusted mean CIMT. Differences remained for combat veterans after adjustment for race, father's education and age at service entry but not years of service and for non-veterans after adjustment for race but not father's education. No differences in carotid plaque were noted. Results do not suggest that combat has a long-term detrimental effect on subclinical atherosclerosis among men.