By itself, post-traumatic stress disorder (PTSD) doesn’t raise the risk of heart disease for U.S. veterans, a new study finds.

“Instead, a combination of physical disorders, psychiatric disorders and smoking — that are more common in patients with PTSD versus without PTSD — appear to explain the association between PTSD and developing cardiovascular disease,” said study author Jeffrey Scherrer. He’s research director in the department of family and community medicine at Saint Louis University School of Medicine in Missouri.

For the study, Scherrer and his colleagues analyzed health records of more than 2,500 veterans with PTSD and more than 1,600 without PTSD. The veterans were aged 30 to 70 and had not been diagnosed with heart disease in the previous 12 months. The study participants were followed for at least three years.

During that time, veterans with PTSD were 41 percent more likely to develop circulatory and heart disease than those without PTSD.

Those with PTSD had significantly higher rates of smoking, depression, anxiety disorders, sleep disorders, type 2 diabetes, obesity, high blood pressure and high cholesterol than those without PTSD, the investigators found.

However, no single condition explained the association between PTSD and heart disease, according to the study published online Feb. 13 in the Journal of the American Heart Association.

The findings may not apply to patients older than 70 or to civilians, the study authors said. In addition, the researchers did not assess lifetime heart disease risk, so its link to PTSD over many decades may differ.

“For veterans, and likely non-veterans, heart disease prevention efforts should focus on helping patients reduce weight, control high blood pressure, cholesterol, type 2 diabetes, depression, anxiety disorders, sleep problems, substance abuse and smoking,” Scherrer said in a journal news release.

While that list is long, he said it is important for patients with many of the conditions to manage all of them.

“Recognizing that PTSD does not preordain cardiovascular disease may empower patients to seek care to prevent and/or manage [heart disease] risk factors,” Scherrer said.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to a healthy heart.