Association of Atherosclerotic Cardiovascular Disease, Hypertension, Diabetes, and Hyperlipidemia with Gulf War Illness Among Gulf War Veterans

Details

• Personal Author:
  Ahmed ST ; Delclos G ; Djotsa AN ; Ghosh S ; Gifford E ; Hauser ER ; Helmer DA ; Li R ; Morgan, Robert ; Richardson P ; Sims K ; Steele L ; Virani SS ; White DL
• Description:
  Background: Approximately 30% of the 700 000 Gulf War veterans report a chronic symptom-based illness of varying severity referred to as Gulf War illness (GWI). Toxic deployment-related exposures have been implicated in the cause of GWI, some of which contribute to metabolic dysregulation and lipid abnormalities. As this cohort ages, the relationship between GWI and atherosclerotic cardiovascular disease (ASCVD) is a growing concern. We evaluated associations between GWI and ASCVD, diabetes, hyperlipidemia, and hypertension in veterans of the Gulf War (1990-1991). Methods and Results: Analysis of survey data collected in 2014 to 2016 from a national sample of deployed Gulf War veterans (n=942) and Veterans Health Administration electronic health record data (n=669). Multivariable logistic regression models tested for associations of GWI with self-reported ASCVD, diabetes, hyperlipidemia, and hypertension, controlling for confounding factors. Separate models tested for GWI associations with ASCVD and risk factors documented in the electronic health record. GWI was associated with self-reported hypertension (adjusted odds ratio [aOR], 1.67 [95% CI, 1.18-2.36]), hyperlipidemia (aOR, 1.46 [95% CI, 1.03-2.05]), and ASCVD (aOR, 2.65 [95% CI, 1.56-4.51]). In the subset of veterans with electronic health record data, GWI was associated with documented diabetes (aOR, 2.34 [95% CI, 1.43-3.82]) and hypertension (aOR, 2.84 [95% CI, 1.92-4.20]). Hyperlipidemia and hypertension served as partial mediators of the association between GWI and self-reported ASCVD. Conclusions: Gulf War veterans with GWI had higher odds of hyperlipidemia, hypertension, diabetes, and ASCVD compared with Gulf War veterans without GWI. Further examination of the mechanisms underlying this association, including a possible shared exposure-related mechanism, is necessary. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Occupational Health Safety
• Keywords:
  Author Keywords: Atherosclerotic Cardiovascular Disease Cardiovascular Disease Diabetes Electronic Health Records Gulf War Illness Gulf War Veterans Hyperlipidemia Hypertension Lipid Disorders Military Personnel Veteran

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• ISSN:
  2047-9980
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  North Carolina ; OSHA Region 4 ; OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  12
• Issue:
  19
• NIOSHTIC Number:
  nn:20069779
• Citation:
  J Am Heart Assoc 2023 Oct; 12(19):e029575
• Contact Point Address:
  Drew A. Helmer, MD, MS, Health Services Research and Development (152), Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030
• Email:
  drew.helmer@bcm.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of Texas Health Science Center, Houston
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of the American Heart Association
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3505dd57b808e549d658a4308b71fed9871fbb6235797c3353865bb6e085896c91491a690d1a6f591f55cebd33530a94d66169c4d4aa4edfc331a2094f47cd19
• Download URL:
  https://stacks.cdc.gov/view/cdc/208135/cdc_208135_DS1.pdf
• File Type:
  [PDF - 392.51 KB ]