Thursday, October 18, 2012

PTSD and Cardiovascular Disease, Medical Treatise and Possible Argument

In a single judge decision, Kaye v. Shinseki, No. 11-1013, the court stated that: "Dr. Ross seems unaware of the thorough studies linking PTSD and cardiovascular disease that were part of the record" The court goes on to order a remand. The studies to which the court was referring included a VA study entitled Risk of selected cardiovascular diseases and posttraumatic stress disorder among former World War II prisoners of war, see abstract below. The veteran in this case argued that the Board violated its duty to assist and Barr because "it relied upon an inadequate medical opinion, which ignored VA studies linking PTSD and heart problems. The studies are significant, as they refute the examiner’s contention that PTSD was not a risk factor for ischemic heart disease, and also render the examiner’s opinion as based upon a faulty factual premise." VA has relied, in prior cases, on a 2003 study finding an increased risk of hypertension and chronic heart disease among World War II veterans diagnosed with PTSD, and a 1997 study finding that Vietnam veterans diagnosed with PTSD had an increased risk of developing circulatory disease. See 69 Fed. Reg. 60,083, 60,087 (Oct. 7, 2004) (Interim Final Rule). If you are seeking PTSD caused heart disease claim, it might be of benefit to get these studies into the record, and read the veterans brief in this case. ===================================== Ann Epidemiol. 2006 May;16(5):381-6. Epub 2005 Jul 1. Risk of selected cardiovascular diseases and posttraumatic stress disorder among former World War II prisoners of war. Kang HK, Bullman TA, Taylor JW. Source U.S. Department of Veterans Affairs, Environmental Epidemiology Service, 810 Vermont Ave Washington, DC 20420, USA. han.kang@hq.med.va.gov Abstract PURPOSE: American World War II (WWII) prisoners of war (POWs) suffered both mental and physical deprivation while interned. The long-term health consequences of the internment were studied for an increased risk of cardiovascular diseases and posttraumatic stress disorder (PTSD). METHODS: This study evaluated healthcare utilization data for 10 years (1991-2000) from Veterans Affairs (VA) and non-VA healthcare providers for 19,442 former WWII POWs and 9728 non-POW controls. The risk of diseases was approximated by odds ratios adjusted for race and age. RESULTS: Collectively, former POWs had statistically significant increased risk of PTSD, and those POWs with PTSD also had statistically significant increased risks of cardiovascular diseases including hypertension and chronic ischemic heart disease when compared to both non-POWs and POWs without PTSD. CONCLUSIONS: Among former WWII POWs, risk of cardiovascular disease is related to having PTSD. PMID: 15994096 [PubMed - indexed for MEDLINE]