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

Prev Med. May-Jun 2010;50(5-6):277-81. doi: 10.1016/j.ypmed.2010.02.009. Epub 2010 Feb 23.


Background: Studies of the cardiovascular consequences of combat stress are few and inconclusive.

Objective: 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.

Methods: 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).

Results: 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.

Conclusion: Results do not suggest that combat has a long-term detrimental effect on subclinical atherosclerosis among men.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • African Americans / statistics & numerical data
  • Age Distribution
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / epidemiology*
  • Carotid Artery Diseases / etiology*
  • Cost of Illness
  • European Continental Ancestry Group / statistics & numerical data
  • Fathers / education
  • Humans
  • Least-Squares Analysis
  • Linear Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Socioeconomic Factors
  • Stress Disorders, Post-Traumatic / complications
  • Stress Disorders, Post-Traumatic / epidemiology
  • Tunica Intima / pathology
  • Tunica Media / pathology
  • United States / epidemiology
  • Veterans / statistics & numerical data*
  • Warfare*