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

Publication ,  Journal Article
Sarah T. Ahmed,, ; Li, R; Richardson, P; Ghosh, S; Steele, L; White, DL; Nono Djotsa, A; Sims, K; Gifford, E; Hauser, E; Virani, SS; Morgan, R ...
Published in: Journal of the American Heart Association
September 29, 2023

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.

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Published In

Journal of the American Heart Association

DOI

ISSN

2047-9980

Publication Date

September 29, 2023

Publisher

Wiley

Related Subject Headings

  • Veterans
  • Surveys and Questionnaires
  • Persian Gulf Syndrome
  • Hypertension
  • Hyperlipidemias
  • Humans
  • Gulf War
  • Diabetes Mellitus
  • Cardiovascular Diseases
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Sarah T. Ahmed, ., Li, R., Richardson, P., Ghosh, S., Steele, L., White, D. L., … Delclos, G. (2023). Association of Atherosclerotic Cardiovascular Disease, Hypertension, Diabetes, and Hyperlipidemia With Gulf War Illness Among Gulf War Veterans. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.123.029575
Sarah T. Ahmed, Rushina, Ruosha Li, Peter Richardson, Saurendro Ghosh, Lea Steele, Donna L. White, Alice Nono Djotsa, et al. “Association of Atherosclerotic Cardiovascular Disease, Hypertension, Diabetes, and Hyperlipidemia With Gulf War Illness Among Gulf War Veterans.” Journal of the American Heart Association, September 29, 2023. https://doi.org/10.1161/JAHA.123.029575.
Sarah T. Ahmed, Li R, Richardson P, Ghosh S, Steele L, White DL, et al. Association of Atherosclerotic Cardiovascular Disease, Hypertension, Diabetes, and Hyperlipidemia With Gulf War Illness Among Gulf War Veterans. Journal of the American Heart Association. 2023 Sep 29;
Sarah T. Ahmed, Rushina, et al. “Association of Atherosclerotic Cardiovascular Disease, Hypertension, Diabetes, and Hyperlipidemia With Gulf War Illness Among Gulf War Veterans.” Journal of the American Heart Association, Wiley, Sept. 2023. Manual, doi:10.1161/JAHA.123.029575.
Sarah T. Ahmed, Li R, Richardson P, Ghosh S, Steele L, White DL, Nono Djotsa A, Sims K, Gifford E, Hauser E, Virani SS, Morgan R, Helmer DA, Delclos G. Association of Atherosclerotic Cardiovascular Disease, Hypertension, Diabetes, and Hyperlipidemia With Gulf War Illness Among Gulf War Veterans. Journal of the American Heart Association. Wiley; 2023 Sep 29;
Journal cover image

Published In

Journal of the American Heart Association

DOI

ISSN

2047-9980

Publication Date

September 29, 2023

Publisher

Wiley

Related Subject Headings

  • Veterans
  • Surveys and Questionnaires
  • Persian Gulf Syndrome
  • Hypertension
  • Hyperlipidemias
  • Humans
  • Gulf War
  • Diabetes Mellitus
  • Cardiovascular Diseases
  • 3201 Cardiovascular medicine and haematology