Date of Award

January 2021

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Robert H. Pietrzak

Abstract

Importance. Cardiovascular disease (CVD) is one of the leading causes of death in the U.S. and is associated with a range of demographic, military, trauma, and clinical characteristics and physical and mental health conditions. Older military veterans may have an increased risk for CVD, given their advanced age and military experiences. However, the prevalence and health burden of CVD in population-based samples has not been well characterized. Objective. To characterize the current prevalence of CVD, and its association with sociodemographic, military, trauma, and clinical variables in a large, contemporary, and nationally representative sample of older U.S. veterans. Design. Cross-sectional study of 3,001 older U.S. military veterans (age 60 and older) using data from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS). Main Outcomes. Veterans were classified according to lifetime CVD status (CVD or no CVD [health care professional diagnoses of heart disease, heart attack, and/or stroke]). To determine the association of CVD with health status, a comprehensive range of mental and physical health variables were assessed using validated self-report assessments. Results. 25.5% of veterans reported having been diagnosed with CVD. Greater age, cumulative trauma burden, nicotine use disorder, and diagnoses of hypertension, high cholesterol, and diabetes were associated with CVD. CVD was independently associated with a range of mental (odds ratios [ORs]= 1.53-2.27) and physical (ORs=1.53-3.43) health conditions. Conclusions and Relevance. 1 in 4 older U.S. veterans reported having been diagnosed with CVD in their lifetimes. CVD was independently associated with a broad range of demographic, clinical, physical, and mental health variables in U.S. veterans, suggesting that CVD is linked to multiple health outcomes. Results highlighted the importance of CVD for prevention and intervention efforts in the older U.S. veteran population.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/01/2022

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