- Comorbid CVD and PTSD affected 2.2% of veterans, versus 23.1% with CVD only and 5.5% with PTSD only.
- CVD+PTSD veterans reported greater lifetime trauma, combat exposure and childhood adversity, with markedly higher odds of MDD, GAD, cognitive disorder, sleep disorder and TBI.
- Comorbidity produced moderate psychosocial and cognitive impairment and increased suicidal ideation and chronic pain, highlighting need for integrated trauma informed care.
Prim Care Companion CNS Disord. 2026 Jul 14;28(4):26m04187. doi: 10.4088/PCC.26m04187.
ABSTRACT
Objective: Cardiovascular disease (CVD) and posttraumatic stress disorder (PTSD) are prevalent and disabling conditions among older US veterans. Both are independently associated with poor physical, mental, and functional outcomes, but little is known about the combined burden. This study aims to examine the prevalence, risk correlates, health comorbidities, and functional outcomes of comorbid CVD+PTSD in older US veterans.
Methods: Data were analyzed from 3,001 US veterans aged 60 years and older who participated in the 2019-2020 National Health and Resilience in Veterans Study. Self-reported CVD, PTSD, health comorbidities, and functional outcomes were examined using weighted bivariate and multivariable analyses.
Results: A total of 23.1% of veterans had CVD only, 5.5% PTSD only, and 2.2% comorbid CVD+PTSD. Veterans with CVD+PTSD were more likely to report combat exposure, childhood adversity, and greater lifetime trauma compared to other groups. Relative to controls, they had particularly elevated odds of major depressive disorder (MDD), generalized anxiety disorder (GAD), cognitive disorder (ie, mild cognitive impairment, dementia, or Alzheimer disease), sleep disorder, and concussion/traumatic brain injury (TBI; odds ratios [ORs] = 4.78-13.27). Compared to CVD-only veterans, those with CVD+PTSD had higher odds of GAD, MDD, cognitive disorder, sleep disorder, suicidal ideation, and chronic pain (ORs = 1.89-9.64). Relative to PTSD-only veterans, they had greater odds of kidney disease, concussion/TBI, MDD, and sleep disorder (ORs = 2.67-4.85). Veterans with CVD+PTSD also showed moderately greater impairments in psychosocial and cognitive functioning compared to single-diagnosis groups (d‘s = 0.50-0.66).
Conclusions: Older veterans with comorbid CVD+PTSD have a markedly elevated burden of health and functional difficulties, underscoring the importance of integrated, trauma-informed care to improve outcomes in this high-risk population.
Prim Care Companion CNS Disord 2026;28(4):26m04187.
Author affiliations are listed at the end of this article.
PMID:42475746 | DOI:10.4088/PCC.26m04187
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