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Journal Title:

BMJ Open


Volume 5, Number 12


BMJ Publishing Group: Open Access | 2015-12, Pages e009334-e009334

Type of Work:

Article | Final Publisher PDF

Abstract: Objectives: Post-traumatic stress disorder PTSD is a well-documented risk factor for cardiovascular disease CVD. However, it is unknown whether another common stress disorder—adjustment disorder—is also associated with an increased risk of CVD and whether gender modifies these associations. The aim of this study was to examine the overall and gender-stratified associations between PTSD and adjustment disorder and 4 CVD events.Design: Prospective cohort study utilising Danish national registry data.Setting: The general population of Denmark.Participants: PTSD n=4724 and adjustment disorder n=64 855 cohorts compared with the general population of Denmark from 1995 to 2011.Primary outcome measures: CVD events including myocardial infarction MI, stroke, ischaemic stroke and venous thromboembolism VTE. Standardised incidence rates and 95% CIs were calculated.Results: Associations were found between PTSD and all 4 CVD events ranging from 1.5 95% CI 1.1 to 1.9 for MI to 2.1 95% CI 1.7 to 2.7 for VTE. Associations that were similar in magnitude were also found for adjustment disorder and all 4 CVD events: 1.5 95% CI 1.4 to 1.6 for MI to 1.9 95% CI 1.8 to 2.0 for VTE. No gender differences were noted.Conclusions: By expanding beyond PTSD and examining a second stress disorder—adjustment disorder—this study provides evidence that stress-related psychopathology is associated with CVD events. Further, limited evidence of gender differences in associations for either of the stress disorders and CVD was found.

Subjects: Health Sciences, Epidemiology - Health Sciences, Mental Health - Health Sciences, General - Research Funding: his work was supported by the Program for Clinical Research Infrastructure PROCRIN established by the Lundbeck Foundation and the Novo Nordisk Foundation, and the Aarhus University Research Foundation, and by a National Institute of Mental Health grant: ‘Constructing a Danish Reaction to Severe Stress Cohort’ 1R21MH094551-01A1, JLG, Principal Investigator.

Keywords: Mental health - Cardiology - Epidemiology -

Autor: Jaimie L Gradus, Dóra Körmendiné Farkas, Elisabeth Svensson, Vera Ehrenstein, Timothy Lash, Arnold Milstein, Nancy Adler, Henr



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