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The years I spent in the awkward embrace of the U.S. Air Force during the Vietnam War didn’t offer much in the way of prestige, honor, or privilege. That was not a time when patriotic bystanders thanked us for our service. Like most of my peers, I was hard-pressed to extract much value from the experience.

It did pay my way through four years of college, which seemed at the time a less-than-equal exchange, and it did enable a guy with zero savings to eventually land a mortgage, which only seemed fair. But the better part of five decades passed before I could admit to myself that those three years, nine months, and six days of military service may have yielded, on balance, slightly more benefits than liabilities.

So, you might imagine my response when I learned the other day that military veterans are twice as likely as those who never served to develop cardiovascular disease (CVD).

That little nugget of negativity, first unearthed in a 2014 paper, was simply a footnote in a study published last month in PLOS Mental Health. The more salient statistic uncovered by Yale University School of Public Health researcher Cailin Arechiga, MPH, and her research team was this: More than one in four veterans over the age of 60 suffer from a malfunctioning heart.

And if that’s not enough to dampen military recruitment rates, there’s this: “Veterans with CVD were also more likely to report having been diagnosed with arthritis, cancer, chronic pain, kidney disease, sleep disorder, migraine, rheumatoid arthritis, and MCI [mild cognitive impairment], dementia, or Alzheimer’s disease.”

Researchers reached these and other conclusions from data provided by 3,001 veterans 60 years old and older who participated in the National Health and Resilience in Veterans Study between 2019 and 2020. Participants answered a series of questions pertaining to their current physical and mental health status. Researchers then used that data to connect the dots between their various afflictions and a number of variables, including type of military service, sociodemographic background, and pre-existing health conditions. Their analysis revealed that 25.2 percent of the participants had been diagnosed with CVD. Among that group, 10.1 percent had suffered a heart attack and 4.5 percent had suffered a stroke.

Arechiga and her team found a direct correlation between trauma experienced during military service and the later development of heart disease. “Two pathways may explain this relationship,” she explains. “First, a biological pathway implicating greater traumatic stress and dysregulation of the stress response systems may act as the catalyst for adverse health outcomes such as CVD. Second, a behavioral pathway, whereby engaging in risky or poor health behaviors, may link trauma and health outcomes such as CVD.”

Earlier research has shown how traumatic experiences often lead to tobacco and drug use, poor dietary practices, and a sedentary lifestyle — all of which increase the risk of heart disease. “These pathways have important clinical relevance for older U.S. veterans, who may experience greater psychological and physical distress due to traumatic exposures during military service,” Arechiga writes.

Study participants were also more likely to be struggling with depression, posttraumatic stress, anxiety disorders, and suicidal ideation, she notes. These are all risk factors for heart disease.

What her research illustrates, Arechiga concludes, is the need for a commitment from our healthcare system to pay closer attention to the health of older vets. “Our finding that CVD is associated with a broad range of mental and physical health conditions in older U.S. veterans highlights the importance and urgency of recognizing CVD as a priority for prevention and treatment efforts in this population.”

I guess I’ve been luckier than most aging vets. After years of ignoring my high blood pressure and hazardous cholesterol levels, a hypertensive crisis sent me to the ER a couple of years ago — forcing me to take seriously the threat of a heart attack or stroke. I’m now managing those issues with the appropriate medications.

But I’m not sure I can blame my heart problems on any trauma I experienced in the miliary. The closest thing to serious trauma that I can recall may have occurred while sitting in a barber’s chair in boot camp watching my naked skull emerge from what was once a full head of hair. And the closest I ever came to a combat zone was when my mobile communications squadron (I was a teletype operator) was deployed from West Germany to central Greece during the 1973 Arab-Israeli war — a little more than 1,500 miles from where the battles raged in the Golan Heights. This was the Air Force, after all, not the Marines.

If anything put me at risk for a heart attack, it was losing the genetic lottery. I inherited from my dad’s side of the family a predisposition to heart disease. My paternal grandfather died of a stroke before I had a chance to meet him, Dad suffered two heart attacks by the time he reached his early 50s, and the vast majority of Dad’s several siblings died from some form of cardiovascular malfunction. If their service in World War II contributed at all to their fate, I suspect it only worsened their already poor odds.

Still, I hope Arechiga’s study will encourage more healthcare providers to focus serious attention on older veterans and their cardiovascular health. It could help save some lives. And it might be a way — however tardy — to express some gratitude for their service.

Craig Cox
Craig Cox

Craig Cox is an Experience Life deputy editor who explores the joys and challenges of healthy aging.

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