Eric Smith

Project title: Combat Exposure and Hypertension in the Post-Deployment Period: A Cohort Study

Degree: MPH | Program: Occupational and Environmental Medicine (OEM) | Project type: Thesis/Dissertation
Completed in: 2011


Background: High blood pressure remains a significant risk factor for coronary heart disease, stroke and heart failure. Stress has been postulated to disrupt cardiovascular equilibrium causing short-term elevations in blood pressure acutely, and hypertension with chronic exposure. Prior studies suggest both traumatic events and stressful occupations are risk factors for hypertension.

Purpose: To determine if exposure to combat is related to the development of hypertension in a cohort of soldiers from Fort Lewis, WA.

Materials and Methods: We used multivariable logistic regression to estimate the 3-year risk of newly reported hypertension in soldiers deployed from Fort Lewis between 2005 and 2008 and who remained enrolled in the Military Health System for one year post deployment. Combat exposure was ascertained by pre- and post-deployment surveys that included a blood pressure measurement and 74 questions on demographics, physical, mental, spiritual and family health. Hypertension was assessed by self-report and by ICD-9 codes. After applying exclusion criteria, 5146 soldiers remained in the cohort.

Results: Newly reported hypertension was observed in 7.6% of the cohort between pre- and post-deployment. Soldiers exposed to combat did not demonstrate statistically significant risk of developing hypertension (adjusted odds ratio: 1.12; 95% CI: 0.84 to 1.53).

Conclusion: Although results were not statistically significant, our findings are generally consistent with previous studies, suggesting that combat exposure may lead to hypertension.