3106 — Gender Differences in Post-Traumatic Stress Disorder and Disease Risk among OEF-OIF Veterans who Use VISN2 Primary Care

Tirone V (Center for Integrated Health Care, Syracuse VA Medical Center), Andersen J (Center for Integrated Health Care, Syracuse VA Medical Center), Wade M (Center for Integrated Health Care, Syracuse VA Medical Center)

Objectives:
Post-traumatic Stress Disorder (PTSD) is associated with increased risk for a variety of physician diagnosed physical health problems (Kimerling et al., 2001). Preliminary data suggests there may be gender differences in the onset and diagnosis of PTSD post-deployment, with implications for differential disease risk trajectories. The present study examined associations between physician diagnosed PTSD and commonly associated physical disease risk categories, as moderated by gender in returning OEF/OIF veterans in VISN2.

Methods:
Participants were OEF/OIF veterans (N = 4416) who visited primary care between September 11, 2001 and January 1, 2008 in the VA Healthcare Network of Upstate New York. Veterans were 89% male, 85% white, 53% active duty, and 48% married, with an average age of 29 (SD = 9). Overall, 28% (n = 1258) had a PTSD diagnosis. A data extraction program, FILEMAN, was utilized to pull data from the VA’s computerized medical record system. Age, gender, marital status, unit type (active or reserve), depression, substance use disorders, PTSD, and disease status data were extracted for each veteran. Disease categories included International Classification of Diagnoses – 9 (ICD-9) codes (circulatory, hypertensive, respiratory, digestive, musculoskeletal, signs and ill-defined conditions, nervous system, endocrine/nutritional/metabolic). Hazard ratios were used to assess the association between PTSD and disease categories in a prospective fashion, controlling for demographic variables.

Results:
After adjusting for demographics, depression, and substance use disorders, men were more likely to have a PTSD diagnosis than women (chi-squared = 9.50, p < .001). Male veterans were 69% more likely to have circulatory problems (p < .01) and six times more likely to have a hypertensive disease (p < .001). No significant differences emerged between men and women on the other categories.

Implications:
Our results suggest that recently returning male veterans may be at increased risk for cardiovascular-related disease. Future investigations should examine if gender differences are related to PTSD symptom characteristics (e.g., hyper-arousal, re-experiencing) or type of trauma exposure (e.g., front-line combat, military sexual assault, etc.).

Impacts:
These data indicate there may be gender differences in cardiovascular disease trajectories in OEF/OIF veterans with PTSD diagnosis. This finding highlights the importance of screening for PTSD in primary care settings and encouraging veterans to attain rapid, concentrated healthcare intervention.