Post-trauma cardiovascular risk factors and subclinical atherosclerosis in young adults following the war in Bosnia and Herzegovina

• Published in: European journal of psychotraumatology 2019-01, Vol.10 (1), p.1601988-1601988
• Main Authors: Vulic, Dusko, Secerov Zecevic, Drenka, Burgic, Marija, Vujkovic, Zoran, Ristic, Sinisa, Marinkovic, Jelena, Medenica, Snezana, Wong, Nathan D.
• Format: Article
• Language: English
• Subjects: Atherosclerosis; Cardiovascular disease; children; Clinical; Enfermedad cardiovascular; factores de riesgo; Health risk assessment; intimal medial thickness; Medical students; niños; Risk factors; trauma; Triglycerides; War; Young adults; 危险因素; 心血管疾病
• ISSN: 2000-8066; 2000-8198; 2000-8066
• DOI: 10.1080/20008198.2019.1601988

Background: Risk of cardiovascular disease (CVD) has been associated with stress from serving in a war, but it has not been established whether children who experience war-related stress are at increased CVD risk. Objective: This study aimed to compare CVD risk factors in young adults according to whether they experienced traumatic events as children during the 1990-1995 war in Bosnia and Herzegovina, and whether those exposed to trauma have evidence of subclinical atherosclerosis. Method: We examined 372 first-year medical students who were preschool children during the war (1990-1995) (average age 19.5 ± 1.7 years, 67% female) in 2007-2010. They completed the Semi-Structured Interview for Survivors of War. CVD risk factors and carotid intima-media thickness (CIMT) measurements were obtained and compared in individuals with and without trauma. We also examined whether increased CIMT was independently associated with trauma after adjustment for other risk factors. Results: From multiple logistic regression, only elevated triglycerides (> 1.7 mmol/l) were associated with a 5.2 greater odds of having experienced trauma. The mean CIMT of subjects with trauma was greater than that of non-trauma-exposed subjects (0.53 mm vs 0.50 mm, p = 0.07). Moreover, trauma was independently associated with higher CIMT (difference = 0.036 mm, p = 0.024) after adjustment for CVD risk factors. Conclusions: We show that most CVD risk factors are associated with post-war trauma in young adults, and, if present, such trauma is associated with higher triglycerides and higher levels of CIMT in multivariable analysis. * Our investigation was to examine whether there are differences in cardiovascular risk factors and subclinical atherosclerosis in persons previously exposed compared to not exposed to trauma during the war in Bosnia and Herzegovina.* We demonstrated that while traditional risk factors are not strongly related to the presence of post-war trauma in young adults, those with greater CIMT appear to have been more likely to have had been prevoiusly exposed to trauma.