Post-trauma cardiovascular risk factors and subclinical atherosclerosis in young adults following the war in Bosnia and Herzegovina

Abstract

Background: Risk of cardiovascular disease (CVD) has been associated with stress from serving in a war, but it has not been established whether children who experience warrelated stress are at increased CVD risk. Objective: This study aimed to compare CVD risk factors in young adults according to whether they experienced traumatic events as children during the 1990-1995 war in Bosnia and Herzegovina, and whether those exposed to trauma have evidence of subclinical atherosclerosis. Method: We examined 372 first-year medical students who were preschool children during the war (1990-1995) (average age 19.5 ± 1.7 years, 67% female) in 2007-2010. They completed the Semi-Structured Interview for Survivors of War. CVD risk factors and carotid intima-media thickness (CIMT) measurements were obtained and compared in individuals with and without trauma. We also examined whether increased CIMT was independently associated with trauma after adjustment for other risk factors. Results: From multiple logistic regression, only elevated triglycerides (> 1.7 mmol/l) were associated with a 5.2 greater odds of having experienced trauma. The mean CIMT of subjects with trauma was greater than that of non-trauma-exposed subjects (0.53 mm vs 0.50 mm, p = 0.07). Moreover, trauma was independently associated with higher CIMT (difference = 0.036 mm, p = 0.024) after adjustment for CVD risk factors. Conclusions: We show that most CVD risk factors are associated with postwar trauma in young adults, and, if present, such trauma is associated with higher triglycerides and higher levels of CIMT in multivariable analysis.

Association of traumatic stress and posttraumatic stress disorder with carotid atherosclerosis: findings from the general population

“…Prior studies have exclusively focussed on specific populations like police officers (Violanti et al, 2006 ), students surviving the Bosnian war (Vulic et al, 2019 ) or Vietnam veterans (Goetz et al, 2014 ). While cIMT was related to both combat exposure and PTSD in middle-aged twin war veterans (Goetz et al, 2014 ), and to traumatic experiences in first-year medical students who were preschool children during the Bosnian war (Vulic et al, 2019 ), it was not associated with PTSD symptoms in police officers (Violanti et al, 2006 ). In line, neither cIMT nor carotid plaque was associated with trauma or PTSD in our study.…”

“…By contrast, in 465 middle-aged twins from the Vietnam Era Twin Registry who were free from CVD, both combat exposure and PTSD were associated with cIMT (Goetz et al, 2014 ). Likewise, among 372 medical students having experienced the long-lasting war in Bosnia–Herzegovina, those with well-defined trauma exposures during the war had a significantly higher cIMT than non-traumatized participants, and trauma was independently associated with higher cIMT after adjustment for CVD risk factors (Vulic et al, 2019 ). Moreover, and from a health care perspective, objective measures of subclinical CVD may help to identify individuals at elevated risk which might be beneficial in planning and implementing primary and secondary prevention strategies, particularly in groups with high-risk for trauma exposure and subsequent PTSD like police or military personnel.…”

Climate Change and Health

“…Топлотни таласи утичу и на повећање смртности, док ће погоршање климатских услова довести до учесталијих промјена и погоршања здравствене ситуације код најтежих болесника. Ријеч је о обољењима са кардиоваскуларним и неуролошким ризицима, алергијским реакцијама и другим акутним реакцијама на високе дневне температуре ваздуха, а могу се јавити и други здравствени проблеми као што су болести изазване бактеријама у храни и води, болести које преносе комарци и птице и друго (Miljković et al 2011;Vujkovic et al 2012;Vulic et al 2019;Škrbić et al 2019;Spasojević et al 2020)…”