Prevalence, correlates, and mental and physical health burden of cardiovascular disease in older U.S. military veterans

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, as well as physical and mental health conditions. Older military veterans may have an increased risk of CVD due to their advanced age and military experiences. To date, however, the prevalence and health burden of CVD in population-based samples of veterans has not been well characterized. This study aimed 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. Data were analyzed from a cross-sectional sample of 3,001 older U.S. military veterans (aged 60 and older) who participated in the National Health and Resilience in Veterans Study (NHRVS). Veterans were classified according to lifetime CVD status (CVD or no CVD, i.e., diagnoses by a healthcare professional 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 was assessed using validated self-report assessments. A total of 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. Collectively, the results of this study suggest that one in four older U.S. veterans has report being diagnosed with CVD in their lifetimes. Given the broad range of physical and mental health conditions associated with CVD, these findings highlight the importance of integrated and multimodal prevention and intervention efforts for this population.