quote:["The study examined over 4,000 Vietnam veterans and found that those with PTSD were more than twice as likely to die of heart disease and those without.]:quote
Geisinger study: PTSD causes early death from heart disease
These links are a fascinating insight into the problems associated with PTSD. Thanks for providing them!
PTSD Causes Early Death From Heart Disease, Study Suggests
ScienceDaily (July 8, 2008) — Vietnam veterans who experienced posttraumatic stress disorder (PTSD) were twice as likely to die from heart disease as veterans without PTSD, a new Geisinger study finds.
In a study published in the July issue of Psychosomatic Medicine, Geisinger Senior Investigator Joseph Boscarino, PhD, MPH examined the prevalence of heart disease, PTSD and other problems in more than 4,000 Vietnam veterans.
The more severe the PTSD diagnosis, the greater the likelihood of death from heart disease, the study showed.
Vietnam veterans with PTSD--like chronic smokers--are at higher risk of early death from heart disease, Dr. Boscarino concluded. Boscarino equated PTSD to smoking two to three packs of cigarettes per day for more than 20 years.
PTSD causes the body to release stress hormones, which leads to the inflammation and damage to the arteries and cardiovascular system damage. Stress hormones also tend to reduce the amount of inflammation-reducing cortisol in the body--though researchers aren't sure why.
"Increased levels of stress hormones and less cortisol from PTSD are a bad combination," Dr. Boscarino explained. "Basically, PTSD just cooks your arteries in this situation."
Dr. Boscarino previously found that people with PTSD had dramatically higher rates of chronic health problems such as psoriasis, arthritis and other inflammatory diseases.
"The science is conclusively showing that if you suffer psychological trauma, it's going to take a toll on your physical health," Dr. Boscarino said. "Getting counseling today is critical to avoiding a related problem tomorrow."
This study excluded patients with a prior history of heart disease and included a national sample of veterans, which is different from prior studies on the topic, Boscarino said.
It is interesting that the studies are done on male veterans and not women. Speaking as a female veteran with PTSD and a heart condition. I have learned the difference between a major panic attack and heart attack. I had a recent cardiac study that showed even with partial block artries the heart is pumping like a "normal " . The beat is weird but "normal" for women. My form of exercise walking ! Sally
Male Combat Veterans Rank High In Heart Disease Risk
......../according to a study presented at the American heart Association's 45th annual Conference of Cardiovascular Disease, Epidemiology and Prevention.
Women were not included in this analysis because so few women veterans were in the study population, Johnson said.
I can't post links but current 'new studies' are including women .
PTSD is a very complex disorder and cannot ever be dismissed as a simple matter.
Dave it is amazing, to me, the extent the VA will go to not to award Heart, Hypertension, as secondary to PTSD.
Here is my reconnaissance:
I saw the C&P doctor and he wrote "less likely", my claim was denied. I went to a medical research institution and they did an exam and said if not ethological the cause also most certainly led to the acceleration and progression of... The same examiner refuted the institution by saying that they were only speculating, and he felt it was due to being overweight. My appeal was denied.
I went back to the institution and told them what they C&P examiner had said, and they agreed with the C&P examiner that “all” Doctors speculate because there is no absolute certainty when it come to illnesses, such as, hypertension and heart related illness. They performed a follow up exam (different than the C&P doctor that made his claim “without an exam”), and wrote their opinion again the same as before, but added that my medical records and treatment from the VA would indicate the same as their findings. Because I was also being treated for sleep disorder (PTSD related), plus treatment and medication for PTSD. Still my appeal again was denied.
So I appealed to the BVA, and had a teleconference hearing. I was very happy with the results. I felt for the first time my case had finally been heard by someone intelligent enough to understand the connection.
Then came the finding of the Judge. He remanded the claim back to the VA for another exam.
Now if anyone is claiming Hypertension and Heart related illness secondary to PTSD pay close attention to what the Judge added to the remand. For my claim to be considered secondary the examiner needs to show that the illness has contributed to over 50% of the illness. Now read this a couple of times and it will sink in.. NO, doctor, none, zero, zip can say with “certainty” that one contributing factor over another contributed what percentage. It can NOT be done, period. I am not making this comment without first doing research.. There is a long list of contributing factors to a person’s hypertension, and it is “impossible” to know with certainty which one contribute what percentage,. So likely hood of the claim ever being awarded is very limited because of the Judges request.
I would like anyone to explain to me how the Judge could have made this request of PTSD being a 50% plus contributing factor? The exam is a waste of time, as the claim, and appeals have been a waste of over four years,. This is not a new problem with Veterans. Veterans have been impacted by PTSD, Hypertension, and Heart related illness since the 1800’s..
My comments are based only on my personal experience, and offered to help other Veterans understand with clarity what they are up against when they file a claim. March on but be armed,
It is better to plan for tomorrow than to worry about what tomorrow will bring because either way tomorrow will come…. Be prepared.
The judge in fact did what the law calls for. In choosing a cause of a disease, it must be determined that one factor is more likely the cause than another. And that is the 50%+ rule. You neeed to make a case for this with the C & P examiner.
How long have you been overweight? Is that a result of sleep problems related to the PTSD? If that is the case then you need to show that you where not overweight before you had sleep problems.
Secondary conditions are hard to prove unless there is only one possible link for it in a patients case. If I was to develop heart problems with my family history, the only known reason is my lung disease. Easy link. So you need to make it easier to link it in your case, and this is a hard link to make.
The overweight occurred as the PTSD shut me down, and depression sit in.. of course how do you prove that because there is no history, because I never knew what PTSD was, much less that I had it until I was diagnosed. Also as research studies have shown both in the US and Canada that when a person does not get the proper amount of sleep the hormone that lets the brain know when we have eaten enough does not work.. Hence we overeat because we remain hungry. There is plenty to contribute to over weight other than being lazy.. If we can control of our thoughts and mind no one would ever have PTSD (an example of how little control we have over our mind).
Anyway there has never been any documentation that I am overweight and being overweight has contributed to my stress and heart related illness.. Either in private practice or the VA. Even the C&P examiner was not saying that my weight contributed to my hypertension he was only using it as an example that a doctor could say whatever they want, and they are only speculating. Just like the example he offered…
Then it may be law, (the 50% rule), and thanks for letting me know that… That the PTSD contributed to at least 50% of the illness. Now that may be but I can say, and my comment can be supported scientifically, that no Doctor can say the % of one symptom over another with any certainty. If they do, and it may satisfy Law (if the Doctor says), which is all we really care about, it still defies science.
This four years has been a real learning experience for me, and to learn how barbaric the system that our Veterans go through to prove their case is an embarrassment. I do not see it changing, but it is a big learning curb, and our Veterans have little if any training in how to deal with an outdated, under funded, under staffed system.
Many thanks, as always for your input Dave, you are a true hero, and patriot in my eyes.
You need a doctor to say that the heart disease is more likely caused by the PTSD, and to document that there is no family history of heart disease, that you have no other factors that might predispose you to heart disease, and that you did not have heart disease before you developed PTSD.
I agree, but the C&P Doctors make their exam, and write their report. Given the opportunity I will give him all the information he will allow. The last time I offered the VA Doctor my tests from the private sector he refused to look at them.
I asked the Cardiology Doctor why I was diagnosed with Sick Sinus Syndrome, and he said that was a “catch-all” when they really did not know, but it was the closest they could come up with… my Doctor in private practice said the same, that he and his colleagues could not understand why my heart was doing what it was doing, and suggested because of my military service I check with the VA to see if it was something related to my service. He also suggested it was close to Sick Sinus Syndrome but lacked some of the symptoms important to diagnosing Sick Sinus Syndrome, but it was the closest… so he added “consider”. Rather than saying I don’t know.
Sick Sinus Syndrome normally comes with a sinoatrial blockage, which causes electrical signals to move too slowly through the sinus node, causing an abnormally slow heart rate. The cardilogist said I do not have a sinoatrial blockage. Still it is the closest thing, so they need to call it something.
So when the C&P examiner does his exam he reads that I “have” sick sinus syndrome, and SSS is not impact by hypertension. So no connection. Fine, but I don’t have SSS. They don’t know what I have.. I do,.
We all age at different rate, but when a person can not get the proper amount of sleep like myself, and receiving treatment from the VA for sleep problems.. Our aging progression is greatly enhanced, . Our organs wear out early because they have been over tasked, without proper rejuvenation. By the time our problems become serious it is to late to reverse. Then Doctors give us a diagnosis that closely fits our condition, and lacks the criteria to be awarded a claim.. How can we the Veteran without a medical degree argue with a Doctor. We can not, guidelines are on the side of the Doctor even if that Doctor lacks the scientific skill to properly diagnose the real problem, and make the connection.
We can do as I did go to a leading research institution for a second opinion “twice” and their opinion is set aside for a C&P examiner.
Will I give up? No because it is not right, not right for me, not right for many thousands of other Veterans.
Dave, a follow up,,
Sick sinus syndrome (SSS) is not a specific disease, but a group of signs or symptoms that indicate the SA node is not functioning properly.
There is no specific, known cause of sick sinus syndrome. Some factors, however, often are associated with the condition, such as: Age-related damage to the heart muscle. Wear-and-tear on the heart over time may weaken the SA node or damage the heart muscle that conducts the electrical signal. As we grow older, we also have fewer "pacing" cells in the heart.
Researchers have noted that the wall of the left ventricle of the heart becomes thicker with age. This thickening allows the heart to pump stronger. As our blood vessels age, they become narrower -- causing blood pressure to increase. The heart compensates for this by becoming stronger and pumping with more force.
Studies have shown that chronic sleep deprivation also contributes to heart disease, gastrointestinal problems, and other medical illnesses. One study on the effects of sleep deprivation showed that a group of men restricted to 4 to 6 hours of sleep per night experienced changes in hormone function and carbohydrate metabolism that mimic aging changes; the lack of sleep was making them older faster.
Bottom line Dave is there is connection between Hypertension, and Heart related illnesses due to PTSD. Especially when considering the impact on our ability to sleep. Sleep deprivation is one of the treatments I am receiving from the VA. The heart just wears out from early aging caused by sleep deprivation. My sleep test, adminstrated by the VA, shows I get about 1.8 hours a night, of rested sleep. I have been examned for and I do not have sleep apnea. I have PTSD.
However the C&P examiner is not going to go through the efforts to make the connection. They, or the ones I have seen, say things like “less likely”, and the leading research institution says “almost certainly“. The Judge? Says remand and give more tests and be sure that the condition is higher than 50%, which is impossible to do.. Because they can not prove a condition and break it down into percentages.
Me? As I have said, tired, very tired, my family has said just forget it and move on, my therapist says she feels I should not give up, but again as I said earlier it is not just me but the thousands of other Veterans that are treated the same, and it is just not right. There is compensation in place for their condition however the system has just made it unreachable for the majority.
Keep coming back!
I have been off the net here for some time. Glad to see you're still around..helping as always.
My story. I was diagnosed and had to have an Aortic Valve Replacement in Feb '92 (came home from Iraq in June '91). VA denied my initial claim an appeal. Now I am 50% connected for PTSD, 57 Years old and have been having more heart problems. New meds, hypertension, stress tests, and symptoms indicate a minor problem in the heart wall.
What would be my best approach to a claim?
I walked around the face of the earth for 38 years with a major birth defect of my heart. The defect was fixed but I have some remaining problems with the heart. I am now being treated along with my PTSD being treated. Stress adds extra problems to treating because panic attacks can and do attack as a heart attack. The local hospitals are aware of the exsiting cardic problems with my heart. I am grateful to God for the healing He has done. My heart functions as a healthy heart with a slightly different beat than "normal".
I wish you all the best, and may you live a long and healthy life.. Thank you for your service.
Sounds as if you have a fairly complicated case here. I join in thanking you for your service.
There is plenty of help available. If you need help accessing the VA system, start with a good VSO or get yourself, a family member or a friend to take you to a Vet Center.
It has been a long time since I last offered any comments. Mostly because I found myself worn out by the log jam of bureaucratic "BS". Here is my update.
I thought we veterans could see the bureaucratic log jam broken up with the appointment of Eric K. Shinseki as Secretary of Veterans Affairs. His BIO, is very impressive http://www1.va.gov/opa/bios/bio_shinseki.asp just as impressive as his bio is his actions.
Finally, relief from the years of VA stonewalling in getting a claim processed for something so obvious. Here is the release of the “Fast Track Process.” ***
Shinseki decided to establish a service connection for Vietnam veterans with three specific illnesses based on the latest evidence of an association with the herbicide referred to Agent Orange. The illnesses affected by the recent decision are B-cell leukemias, such as hairy cell leukemia; Parkinson's disease, and ischemic heart disease and brings to 15 the number of presumed illnesses recognized by the Department of Veterans Affairs as being associated with Vietnam service.
Used in Vietnam to defoliate trees and remove concealment for the enemy, Agent Orange left a legacy of suffering and disability that continues to the present. Between January 1965 and April 1970, an estimated 2.6 million military personnel who served in Vietnam may have been exposed to sprayed Agent Orange.
In practical terms, veterans who served in Vietnam during the war and who have a "presumed" illness don't have to prove an association between their illnesses and their military service. This "presumption" simplifies and speeds up the application process for benefits.
"We must do better reviews of illnesses that may be connected to service, and we will," Shinseki said. "Veterans who endure health problems deserve timely decisions based on solid evidence.”
Once this decision was made by the Secretary of Veterans Affairs the process started, but was suddenly put on hold. Why? And who can put the action of The Secretary of Veterans Affairs on hold? The President? Congress? I really don’t know so I will not make up a story that sounds good. I do have a personal opinion, but I will keep my opinion private.
During his confirmation hearing, it sounded like he had the support of Congress, and that Congress understood the need to support our Military that risk it all in service to our Country.
It would appear that freezing of the claims process had to come from the President or Congress. This is NOT good news for the veteran because we may see the process once again get buried into one of those committees to evaluate. Committee evaluation is a polite term for delay – a way to bury it while figuring out how to get out of the "costly" decision made by the secretary.
Our Country is better than this and supports our military just as our military has supported and defended our country, even at risk of their own lives.
I have been working on my claim since 2004, and it is currently at the BVA. I have worked very hard to accumulate evidence supporting my claim, and the VA has worked very hard to deny my claim based on superficial reasons, rather than facts.
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