Citation

Lenane Z, Peacock E, Joyce C, Frohlich ED, Re RN, Muntner P, Krousel-Wood M. Am. J. Geriatr. Psychiatry 2019; 27(3): 310-321.

Affiliation

Department of Medicine, Tulane University School of Medicine (ZL, EP, MK), New Orleans; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (ZL, MK), New Orleans; San Mateo County Behavioral Health and Recovery Services (ZL), San Mateo, CA; Department of Public Health Sciences, Stritch School of Medicine, Loyola University (CJ), Chicago; Ochsner Clinic Foundation (EDF, RNR, MK), New Orleans; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (PM), Birmingham, AL. Electronic address: mawood@tulane.edu.

Copyright

(Copyright © 2019, American Association for Geriatric Psychiatry, Publisher Elsevier Publishing)

DOI

10.1016/j.jagp.2018.11.006

PMID

30581139

Abstract

OBJECTIVE: To determine the association of post-traumatic stress disorder (PTSD) symptoms following Hurricane Katrina with incident cardiovascular disease (CVD) events in older, hypertensive, community-dwelling adults both overall and stratified by age, sex, and race.

METHODS: This was a prospective cohort study performed in Southeastern Louisiana 12-24 months following Hurricane Katrina through February 2011. Participants were community-dwelling older adults (n = 2,073) enrolled in the Cohort Study of Medication Adherence Among Older Adults with no known history of CVD events. PTSD symptoms were assessed via telephone interview 12-24 months following Hurricane Katrina using the PTSD CheckList-Specific Version. The presence of PTSD symptoms was defined by scores greater than or equal to 37. Incident CVD events (stroke, myocardial infarction, hospitalization for congestive heart failure, or CVD death) were identified and adjudicated over a median 3.8-year follow-up period.

RESULTS: Overall, 8.6% of participants screened positive for PTSD symptoms, and 11.6% had an incident CVD event during follow-up. PTSD symptoms were associated with an adjusted hazard ratio (aHR) for CVD events of 1.7 (95% confidence interval [CI], 1.1, 2.6). The association was present among blacks (aHR, 3.3, 95% CI, 1.7, 6.3) but not whites (aHR, 0.9, 95% CI, 0.4, 1.9); the interaction of PTSD symptoms and race on CVD events was statistically significant.

CONCLUSION: PTSD symptoms following Hurricane Katrina were associated with a higher risk of incident CVD in older adults with hypertension, with a stronger association in blacks compared with whites.

Copyright © 2018 Elsevier Ltd. All rights reserved.

Language: en

Keywords

Hurricane Katrina; PTSD symptoms; cardiovascular events; older adults; race; sex