Comparison of Cardiovascular Health Between US Army and Civilians

Shrestha, Anne; Ho, Tiffany; Vie, Loryana L.; Labarthe, Darwin R.; Scheier, Lawrence M.; Lester, Paul B.; Seligman, Martin E. P.

doi:10.1161/jaha.118.009056

Cited by 25 publications

(24 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, one study ( n = 303 223; mean age 31 years) reported 15.6% prevalence of hypertension among U.S. veterans with a mental health diagnosis excluding PTSD and 30.8% prevalence among those with PTSD with or without another mental health diagnosis (Cohen et al ., 2009). In a cross-sectional study also drawing on data from active-duty U.S. Army soldiers but weighted to the 2012 U.S. Army active-duty population, 5% of soldiers were estimated to have hypertension and 64.7% were estimated to be pre-hypertensive at the time of assessment in 2012 (Shrestha et al ., 2019). Thus, findings from this sample do support the notion that individuals in the military are at higher risk of developing hypertension relatively early in life.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, if age-related increases in blood pressure could be prevented or lessened, the burden of CVD might be substantially reduced (Rieder, 2007; Institute of Medicine, 2010). Certain populations have also been identified as having elevated risk of developing hypertension relatively early in life, including those exposed to major occupational stressors, like service members and veterans (Yu et al ., 2003; Shrestha et al ., 2019). Besides occupational status, other sociodemographic correlates of high blood pressure have been identified.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Optimism and risk of incident hypertension: a target for primordial prevention

Kubzansky

Boehm

Allen

et al. 2020

Epidemiol Psychiatr Sci

Self Cite

View full text Add to dashboard Cite

Aims Optimism is associated with reduced cardiovascular disease risk; however, few prospective studies have considered optimism in relation to hypertension risk specifically. We investigated whether optimism was associated with a lower risk of developing hypertension in U.S. service members, who are more likely to develop high blood pressure early in life. We also evaluated race/ethnicity, sex and age as potential effect modifiers of these associations. Methods Participants were 103 486 hypertension-free U.S. Army active-duty soldiers (mean age 28.96 years, 61.76% White, 20.04% Black, 11.01% Hispanic, 4.09% Asian, and 3.10% others). We assessed optimism, sociodemographic characteristics, health conditions, health behaviours and depression status at baseline (2009–2010) via self-report and administrative records, and ascertained incident hypertension over follow-up (2010–2014) from electronic health records and health assessments. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and adjusted models for a broad range of relevant covariates. Results Over a mean follow-up of 3.51 years, 15 052 incident hypertension cases occurred. The highest v. lowest optimism levels were associated with a 22% reduced risk of developing hypertension, after adjusting for all covariates including baseline blood pressure (HR = 0.78; 95% CI = 0.74–0.83). The difference in hypertension risk between the highest v. lowest optimism was also maintained when we excluded soldiers with hypertension in the first two years of follow-up and, separately, when we excluded soldiers with prehypertension at baseline. A dose–response relationship was evident with higher optimism associated with a lower relative risk (p < 0.001). Higher optimism was consistently associated with a lower risk of developing hypertension across sex, age and most race/ethnicity categories. Conclusions In a diverse cohort of initially healthy male and female service members particularly vulnerable to developing hypertension, higher optimism levels were associated with reduced hypertension risk independently of sociodemographic and health factors, a particularly notable finding given the young and healthy population. Results suggest optimism is a health asset and a potential target for public health interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Optimism and risk of incident hypertension: a target for primordial prevention

Kubzansky

Boehm

Allen

et al. 2020

Epidemiol Psychiatr Sci

Self Cite

View full text Add to dashboard Cite

show abstract

“…A diagnosis of high blood pressure for, example, was established in 18% of cases, similar to our results (19.51%). Preventive health interventions aimed at blood pressure regulation of service members through physical activity and nutrition may provide significant improvements in cardiovascular health not only for the active military personnel but also in civilians (13,25). In addition to the health care status of the military personnel, reduction of the health care costs is also very important for each national army force.…”

Section: Discussionmentioning

confidence: 99%

Cost Analysis of Health Examination Screening Program for Ischemic Heart Disease in Active-Duty Military Personnel in the Middle-Income Country

Simić

Ratković

Dragojevic-Simic

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

Cardiovascular diseases, including ischemic heart disease, are the most common causes of morbidity and death in the world, including Serbia, as a middle-income European country. The aim of the study was to determine the costs of preventive examinations for ischemic heart disease in active-duty military personnel, as well as to assess whether this was justified from the point of view of the limited health resources allocated for the treatment of the Republic of Serbia population. This is a retrospective cost-preventive study which included 738 male active-duty military personnel, aged from 23 to 58. The costs of primary prevention of ischemic heart disease in this population were investigated. Out of 738 subjects examined, arterial hypertension was detected in 101 subjects (in 74 of them, arterial hypertension was registered for the first time, while 27 subjects were already subjected to pharmacotherapy for arterial hypertension). Average costs of all services during the periodic-health-examination screening program were €76.96 per subject. However, average costs of all services during the periodic-health-examination screening program for patients with newfound arterial hypertension and poorly regulated arterial hypertension were €767.54 per patient and €2,103.63 per patient, respectively. Since periodic-health-examination screening program in military personnel enabled not only discovery of patient with newfound arterial hypertension but also regular monitoring of those who are already on antihypertensive therapy, significant savings of €690.58 per patient and €2,026.67 per patient can be achieved, respectively. As financial resources for providing health care in Serbia, as a middle-income country, are limited, further efforts should be put on screening programs for ischemic heart disease due to possible significant savings.

show abstract

“…Among included studies (26 cross-sectional and four cohort studies), 11 studies conducted in India [7,8,[17][18][19][20][21][22][23][24][25], four in the USA [26][27][28][29], two in Iran [30,31], two in Saudi Arabia [32,33], one in Brazil [34], one in Sweden [35], one in Canada [36], one in Poland [37], one in Zambia [38], one in Jordan [39], one in Guinea-Bissau [40], one in Thailand [41], one in Brunei [42], one in Sri Lanka [43], and one in Ethiopia [6], with report of diabetes (n = 30) and prediabetes (n = 9) prevalence. Studies participants consisted of military personnel, soldiers, and conscripts, as well as police personnel and o cer.…”

Section: Description Of Studiesmentioning

confidence: 99%

The prevalence of type 2 diabetes and prediabetes among armed forces personnel: a systematic review and meta-analysis

Fathalipour

Taghdir

Hassanipour

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Previous studies of diabetes among armed forces personnel did not assess a comprehensive disease prevalence. We conducted a systematic review and meta-analysis to estimate the prevalence of type 2 diabetes and prediabetes among military personnel and police officers.Methods: We carried out a systematic search on electronic databases from January 2000 to July 2020. All studies with a report of the prevalence of diabetes and/or prediabetes among armed forces personnel were selected. The Cochran test and I2 statistics were used to determine the heterogeneity of the studies. Random- or fixed-effects model, along with subgroup analysis on diabetes or prediabetes as well as the component of armed forces, was carried out to determine the overall prevalence. All analyses were conducted using STATA software.Results: Among 858 citations, 30 studies were entered into the meta-analysis, involving 1879170 individuals. The meta-analysis estimated the prevalence of type 2 diabetes among the military personnel (9.15%; 95% confidence intervals [CI]: 5.35-12.96) and police officers (9.58%; CI: 5.98-13.18). The overall prevalence of prediabetes among the military personnel and the police officers were 7.32% (CI: 4.22-10.42) and 6.35% (CI: 5.26-7.44), respectively. Conclusion: The prevalence of diabetes and prediabetes among armed forces was consistent with global reports among the general population. These results will inform policy-makers and healthcare providers to find solutions and help to take action to reduce diabetes risk factors on a wider scale, particularly among armed forces personnel.

show abstract

Comparison of Cardiovascular Health Between US Army and Civilians

Cited by 25 publications

References 29 publications

Optimism and risk of incident hypertension: a target for primordial prevention

Optimism and risk of incident hypertension: a target for primordial prevention

Cost Analysis of Health Examination Screening Program for Ischemic Heart Disease in Active-Duty Military Personnel in the Middle-Income Country

The prevalence of type 2 diabetes and prediabetes among armed forces personnel: a systematic review and meta-analysis

Contact Info

Product

Resources

About