Table 1.

Prospective studies of posttraumatic stress disorder (PTSD) and incident cardiovascular disease and type 2 diabetes

Study	N	Sample	PTSD Assessment	Clinical Outcome	HR (95% confidence interval)e	HR Adjusted for Depression (95% confidence interval); Depression Assessment	Mean Age at Baseline	Mean Follow- up, year	Covariates
Boscarino et al., 2008a	4328	US Vietnam era veterans	Self-report based on DSM-III criteria	Heart disease mortality	2.25 (1.02–4.95)	2.06 (0.92–4.62); Medical record	36.3	15	War theater status, age, intelligence, smoking, BMI, depression history
Jordan et al., 2011a	39324	World Trade Center survivors	PCL > 44	Self-reported physician- diagnosed heart disease	1.64 (1.42–1.91)	NA	43.9	2.9	Age, race/ethnicity, education, marital status, smoking, hypertension, diabetes
Kubzansky et al, 2007a	1002	US Vietnam War era veterans	Mississippi Scale for Combat- Related PTSD (mean + 2 SD)	Nonfatal MI and CHD mortality	1.42 (1.03–1.95)	1.30 (0.92–1.80); CES-D	63	15	Age, smoking, systolic and diastolic blood pressure, total cholesterol, BMI, family history of CHD, education, alcohol
Kubzansky et al, 2009a	1059	Baltimore, MD women	Diagnostic Interview Schedule for DSM-III	Angina, nonfatal MI, CHD mortality, other cardiac death	3.28 (1.17–8.90)	2.78 (1.10–7.59); DIS	44.4	13	Age, race/ethnicity, smoking, history of high blood pressure, history of diabetes, alcohol use, education, income
Scherrer et al, 2010a	355999	US military veterans	2 outpatient or 1 inpatient PTSD diagnosis codes (ICD-9- CM: 309.81)	Incident MI (ICD-9- CM codes 410–411)	1.39 (1.33–1.46) Age- adjusted only	1.16 (1.00–1.35); ICD-9	55.7	7	Age, sex, race, marital status, insurance, diabetes, hypertension, hyperlipidemia, obesity, alcohol, nicotine
Vaccarino et al., 2013a	562	US Vietnam War era veterans (twin study)	Diagnostic Interview Schedule for DSM-III	Self-reported hospital admission for heart disease	2.20 (1.2–4.2)	2.19 (1.1–4.1)	42.6	13	Age, education, family income, alcohol, smoking, physical activity, hypertension
Gradus et al., 2015b	4724	Danish population	ICD-10	MI, Stroke, Ischaemic stroke, Venous thromboembolism	1.5 (1.1–1.9) 1.7 (1.4–2.1) 1.8 (1.4–2.4) 2.1 (1.7–2.7)	NA	39.3	7.9	None.
Sumner et al. 2015	49928	US nurses	Short Screening Scale for DSM-IV PTSD	MI, stroke	Trauma/no symptoms: 1.38 (1.09–1.75) Trauma/1–3 symptoms: 0.90 (0.65–1.25) Trauma/4+ symptoms: 1.30 (0.97–1.74)	Trauma/no symptoms: 1.48 (1.15–1.91) Trauma/1–3 symptoms: 1.07 (0.75–1.51) Trauma/4+ symptoms: 1.53 (0.90–2.61)	35	20	Age, race/ethnicity, parental education, maternal /paternal history of MI or stroke, 5- year somatype, BMI, smoking, alcohol intake, physical activity diet quality, hypertension, type 2 diabetes, hormone therapy, ADM use
Beristianos et al., 2015c	138,341	US veterans	ICD-9-CM	Cerebrovascular disease, congestive heart failure, MI, and peripheral vascular disease	1.50 (1.38–1.63)	1.45 (1.33–1.58)	67.8	~10	Age, sex, zipcode, education, income, TBI, dementia, renal disease, hypertension, diabetes, chronic pulmonary disease, cancer, depression, bipolar disorder, generalized anxiety disorder, panic disorder, phobic disorder, substance abuse, alcohol abuse, tobacco dependence
Roy et al., 2015	8248	US veterans	ICD-9	Heart failure	NA	1.47 (1.13–1.92)	63.8	7.2	Age, BMI, diabetes, hyperlipidemia, hypertension, depression, anxiety, tobacco use, substance use disorder, marital status, combat service, period of military service
Chen et al., 2015	26085	Taiwanese population	ICD-9	Ischaemic and Haemorrhagic stroke	3.37 (2.44–4.67)	NA	36.7	7	Age, gender, level of urbanization, income-related insured amount
Vaccarino et al., 2014	4340	US Vietnam War era veterans	DSM-IIIR	Type 2 diabetes	1.09 (0.81–1.45)	1.18 (0.91–1.62)	36	19.4	Age, race, ethnicity, marital status, education, branch of service, enlistment year, service in SE Asia, military rank, cigarette smoking, alcohol use, physical activity
Boyko et al., 2010	44754	US Service members	DSM-IV	Type 2 diabetes	NA	2.06 (1.31–3.26)	36.3	3	Age, race, ethnicity, BMI, education, enlistment status, reserve vs. active duty, panic disorder, depression interaction with gender
Roberts et al., 2015d	54282	US nurses	Short Screening Scale for DSM-IV PTSD	Type 2 diabetes	Trauma/no symptoms: 1.22 (1.10–1.35) Trauma/1–3 symptoms: 1.36 (1.20–1.55) Trauma/4–5 symptoms: 1.41 (1.22–1.62) Trauma/6–7 symptoms: 1.48 (1.26–1.73)	Trauma/no symptoms: 1.20 (1.08–1.33) Trauma/1–3 symptoms: 1.30 (1.15–1.48) Trauma/4–5 symptoms: 1.30 (1.12–1.50) Trauma/6–7 symptoms: 1.33 (1.13–1.56)	NA	22	Race, somatotype at 5 years, parental education, maternal and paternal type 2 diabetes , BMI, smoking, physical activity, diet, alcohol intake

Abbreviations: ADM = antidepressant medication; BMI = body mass index; CES-D = Center for Epidemiologic Studies Depression Scale; CHD = coronary heart disease; DIS = NIMH Diagnostic Interview Schedule; DSM = Diagnostic and Statistical Manual of Mental Disorders; PCL = PTSD Checklist, MI = myocardial infarction; ICD = International Classification of Diseases; ,TBI = traumatic brain injury, SE = Southeast , NA = not applicable

^afrom (Edmondson et al., 2013)

^bEstimate is an SIR

^cThe HR Not Adjusted for Depression means no adjustment for depression, dysthymia, BPD, GAD, panic disorder or phobic disorder.

^dDepression variable was anti-depressant medication not diagnosis of depression

^eMultivariate adjusted Hazard Ratio adjusting for listed covariates except where indicated otherwise.