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Association between combat-related traumatic injury and cardiovascular risk

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Title: Association between combat-related traumatic injury and cardiovascular risk
Authors: Boos, C
Schofield, S
Cullinan, P
Dyball, D
Fear, N
Bull, A
Pernet, D
Bennett, A
Item Type: Journal Article
Abstract: Objective The association between combat-related traumatic injury (CRTI) and cardiovascular risk is uncertain. This study aimed to investigate the association between CRTI and both metabolic syndrome (MetS) and arterial stiffness. Methods This was a prospective observational cohort study consisting of 579 male adult UK combat veterans (UK-Afghanistan War 2003–2014) with CRTI who were frequency-matched to 565 uninjured men by age, service, rank, regiment, deployment period and role-in-theatre. Measures included quantification of injury severity (New Injury Severity Score (NISS)), visceral fat area (dual-energy X-ray absorptiometry), arterial stiffness (heart rate-adjusted central augmentation index (cAIx) and pulse wave velocity (PWV)), fasting venous blood glucose, lipids and high-sensitivity C reactive protein (hs-CRP). Results Overall the participants were 34.1±5.4 years, with a mean (±SD) time from injury/deployment of 8.3±2.1 years. The prevalence of MetS (18.0% vs 11.8%; adjusted risk ratio 1.46, 95% CI 1.10 to 1.94, p<0.0001) and the mean cAIx (17.61%±8.79% vs 15.23%±8.19%, p<0.0001) were higher among the CRTI versus the uninjured group, respectively. Abdominal waist circumference, visceral fat area, triglycerides, estimated insulin resistance and hs-CRP levels were greater and physical activity and high-density lipoprotein-cholesterol lower with CRTI. There were no significant between-group differences in blood glucose, blood pressure or PWV. CRTI, injury severity (↑NISS), age, socioeconomic status (SEC) and physical activity were independently associated with both MetS and cAIx. Conclusions CRTI is associated with an increased prevalence of MetS and arterial stiffness, which are also influenced by age, injury severity, physical activity and SEC. The longitudinal impact of CRTI on clinical cardiovascular events needs further examination.
Issue Date: 16-Feb-2022
Date of Acceptance: 28-Oct-2021
URI: http://hdl.handle.net/10044/1/92796
DOI: 10.1136/heartjnl-2021-320296
ISSN: 1355-6037
Publisher: BMJ Publishing Group
Start Page: 367
End Page: 374
Journal / Book Title: Heart
Volume: 108
Issue: 5
Copyright Statement: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Sponsor/Funder: Ministry Of Defence
Defence Medical Rehabilitation Centre
The Advance (Armed Services Trauma Rehabilitation Outcome Study) Charity
Funder's Grant Number: nil
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
metabolic syndrome
risk factors
metabolic syndrome
risk factors
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Publication Status: Published
Online Publication Date: 2021-11-25
Appears in Collections:Bioengineering
National Heart and Lung Institute
Faculty of Medicine
Faculty of Engineering

This item is licensed under a Creative Commons License Creative Commons