The impact of PTSD on risk of cardiometabolic diseases: a national patient cohort study in Norway

Grethe Emilie Roer; Lars Lien; Ingeborg Bolstad; Jan O Aaseth; Dawit Shawel Abebe

doi:10.1186/s12888-023-04866-x

The impact of PTSD on risk of cardiometabolic diseases: a national patient cohort study in Norway

BMC Psychiatry. 2023 May 20;23(1):349. doi: 10.1186/s12888-023-04866-x.

Authors

Grethe Emilie Roer^{1

2}, Lars Lien^{3

4}, Ingeborg Bolstad⁴, Jan O Aaseth^{4

5}, Dawit Shawel Abebe^{3

6}

Affiliations

¹ Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.O. Box 104, NO-2381, Brumunddal, Norway. grethe.emilie.roer@sykehuset-innlandet.no.
² Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, NO-0130, Oslo, Norway. grethe.emilie.roer@sykehuset-innlandet.no.
³ Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.O. Box 104, NO-2381, Brumunddal, Norway.
⁴ Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.O. Box 400, NO-2418, Elverum, Norway.
⁵ Research Department, Innlandet Hospital Trust, P.O. Box 104, NO-2381, Brumunddal, Norway.
⁶ Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, NO-0130, Oslo, Norway.

Abstract

Background: Posttraumatic stress disorder (PTSD) is associated with cardiometabolic diseases, concurrent anxiety, alcohol use disorder and depression. The relationship between PTSD and cardiometabolic diseases are still unclear, and less is known about the effects of socioeconomic status, comorbid anxiety, comorbid alcohol use disorder and comorbid depression. The study, therefore, aims to examine the risk of developing cardiometabolic diseases including type 2 diabetes mellitus over time in PTSD patients, and to what extent socioeconomic status, comorbid anxiety, comorbid alcohol use disorder and comorbid depression attenuate associations between PTSD and risk of developing cardiometabolic diseases.

Method: A retrospective, register-based cohort study with 6-years follow-up of adult (> 18 years) PTSD patients (N = 7 852) compared with the general population (N = 4 041 366), was performed. Data were acquired from the Norwegian Patient Registry and Statistic Norway. Cox proportional regression models were applied to estimate hazard ratios (HRs) (99% confidence intervals) of cardiometabolic diseases among PTSD patients.

Results: Significantly (p < 0.001) higher age and gender adjusted HRs were disclosed for all cardiometabolic diseases among PTSD patients compared to the population without PTSD, with a variation in HR from 3.5 (99% CI 3.1-3.9) for hypertensive diseases to HR = 6.5 (5.7-7.5) for obesity. When adjusted for socioeconomic status and comorbid mental disorders, reductions were observed, especially for comorbid depression, for which the adjustment resulted in HR reduction of about 48.6% for hypertensive diseases and 67.7% for obesity.

Conclusions: PTSD was associated with increased risk of developing cardiometabolic diseases, though attenuated by socioeconomic status and comorbid mental disorders. Health care professionals should be attentive towards the burden and increased risk that low socioeconomic status and comorbid mental disorders may represent for PTSD patients' cardiometabolic health.

Keywords: Alcohol use disorder; Cardiovascular diseases; Cohort study; Comorbidity; Depression; Diabetes mellitus; Epidemiology; Metabolic diseases; Posttraumatic stress disorder; Register data.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Alcoholism* / epidemiology
Cardiovascular Diseases* / epidemiology
Cohort Studies
Comorbidity
Diabetes Mellitus, Type 2* / epidemiology
Humans
Obesity / epidemiology
Retrospective Studies
Stress Disorders, Post-Traumatic* / epidemiology