Associations among Pain, PTSD, mTBI, and Heart Rate Variability in Veterans of Operation Enduring and Iraqi Freedom: A Pilot Study

Tan, Gabriel; Fink, Brandi C.; Dao, Tam K.; Hebert, Russell; Farmer, Lorie S.; Sanders, April; Pastorek, Nicholas J.; Gevirtz, Richard

doi:10.1111/j.1526-4637.2009.00712.x

Cited by 81 publications

(61 citation statements)

References 54 publications

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“…For instance, HRV was found to be lower in chronic low back pain patients with moderate levels of self-reported functional impairment compared to those with minimal levels of impairment [12]. Consistent with our findings, the previous literature also has found increased levels of anxiety to be associated with lower HRV in individuals with post-myocardial infarction [17] and more pain has been associated with lower HRV in returning OEF/OIF veterans [40]. Thus, our findings in general support and extend previous research in that we found better physical functioning was related to increases in HRV in chronic benign pain while pain sensations were associated with decreases in HRV.…”

Section: Discussionsupporting

confidence: 93%

Health and distress predictors of heart rate variability in fibromyalgia and other forms of chronic pain

Mostoufi¹,

Afari²,

Ahumada³

et al. 2012

Journal of Psychosomatic Research

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Section: Discussionsupporting

confidence: 93%

Health and distress predictors of heart rate variability in fibromyalgia and other forms of chronic pain

Mostoufi¹,

Afari²,

Ahumada³

et al. 2012

Journal of Psychosomatic Research

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“…We identified traumatic brain injury (TBI) in addition to other neurological, mental health, and medical comorbidities using algorithms validated for use with ICD-9-CM codes and which were used in our previous studies [14]. Consistent with prior studies using administrative data, identification of all comorbidities except TBI (where policy recommends a single diagnosis for TBI) required individuals to be diagnosed two times at least seven days apart for outpatient diagnosis or a single inpatient diagnosis [15,16].…”

Section: Comorbiditiesmentioning

confidence: 97%

Antiepileptic drug prescribing patterns in Iraq and Afghanistan war veterans with epilepsy

Rohde

Baca²,

Cott

et al. 2015

Epilepsy & Behavior

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“…Postulated mechanisms include sympathetic activation, which may over time result in cardiac autonomic dysfunction. 32,33 However, the low diagnostic yield of cardiac catheterization among women veterans might also indicate that screening and referral for catheterization needs improvement. Additional research is needed to better understand the referral patterns at the VA; unfortunately, details about the description and nature of chest pain were not available in the current study.…”

Section: Discussionmentioning

confidence: 99%

“…27,28 Depression, anxiety, and other psychological disorders can also manifest physical symptoms, such as chest pain, even in the absence of CAD. [29][30][31] Because depression and PTSD are associated with decreased quality of life, persistent chest pain, increased cardiovascular risk, and worse cardiovascular outcomes, [32][33][34][35] the high rates observed in the veteran population clearly warrant attention.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Outcomes of Women Veterans Undergoing Cardiac Catheterization in the Veterans Affairs Healthcare System

Davis

Maddox

Langner

et al. 2015

Circ: Cardiovascular Quality and Outcomes

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C oronary artery disease (CAD) remains the leading cause of death among women in the United States.1 Prior research has demonstrated that women with CAD are typically older than men and have more risk factors, such as diabetes mellitus, 2 hypertension, 3,4 hyperlipidemia, 5 obesity, 6 and congestive heart failure.4,7 Despite these higher rates of CAD risk factors, women have less obstructive CAD. 4,8 Studies are conflicting regarding whether women are treated less aggressively than their male counterparts. 9-15 Women tend to have more complications and worse outcomes after cardiac catheterization 16 and are less likely to receive evidence-based medical therapy after discharge. 17Women who have served in the military may have an even higher risk of CAD than nonveteran women, given the overall worse health status and higher number of CAD risk factors in the veteran population, 18-20 but little is known about the characteristics and treatment of women veterans suspected of having clinically significant CAD. The number of women seeking care at veterans affairs (VA) facilities has doubled over the past decade, 21 providing a unique opportunity to understand cardiac care and outcomes among women veterans. By extension, these lessons could improve our understanding of the sex differences noted in nonveteran cardiac populations.Background-The number of women veterans is increasing, yet little is known about their cardiovascular risk factors, coronary anatomy, cardiac treatments, and outcomes after cardiac catheterization. Prior studies have shown that nonveteran women have more risk factors, receive less aggressive treatment, and have worse outcomes, despite having less obstructive coronary artery disease than men. Whether these differences exist among women veterans in the veterans affairs healthcare system is unknown. Methods and Results-Data on 85 936 veterans (3181 women) undergoing initial cardiac catheterization between October 1, 2007, and September 30, 2012, were examined using the national veterans affairs Clinical Assessment Reporting and Tracking (CART) Program. Sex differences in demographics, indications, coronary anatomy, cardiac treatments, and outcomes were analyzed. Women veterans were younger (56.9 versus 63.0 years, P<0.0001) with fewer traditional cardiovascular risk factors, but with more obesity, depression, and posttraumatic stress disorder than men. Women had lower rates of obstructive coronary artery disease than men (22.6% versus 53.3%). Rates of procedural complications were similar in both genders. Adjusted outcomes at 1 year showed women had lower mortality (hazard ratio, 0.74; confidence interval, 0.60-0.92) and less all-cause rehospitalization (hazard ratio, 0.87; confidence interval, 0.82-0.93), but no difference in rates of unplanned percutaneous coronary intervention. Conclusions-Women veterans undergoing catheterization are younger, have more obesity, depression, and posttraumatic stress disorder, less obstructive coronary artery disease, and similar long-term outcomes, compared with m...

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Associations among Pain, PTSD, mTBI, and Heart Rate Variability in Veterans of Operation Enduring and Iraqi Freedom: A Pilot Study

Cited by 81 publications

References 54 publications

Health and distress predictors of heart rate variability in fibromyalgia and other forms of chronic pain

Health and distress predictors of heart rate variability in fibromyalgia and other forms of chronic pain

Antiepileptic drug prescribing patterns in Iraq and Afghanistan war veterans with epilepsy

Characteristics and Outcomes of Women Veterans Undergoing Cardiac Catheterization in the Veterans Affairs Healthcare System

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