The mean baseline age of the veterans was 68.8 years, and 174 806 (96.5%) were men. To determine whether PTSD is associated with the risk of developing dementia among older US veterans receiving treatment in the Department of Veterans Affairs medical centers.Ī stratified, retrospective cohort study conducted using the Department of Veterans Affairs National Patient Care Database.ĭepartment of Veterans Affairs medical centers in the United States.Ī total of 181 093 veterans 55 years or older without dementia from fiscal years 1997 through 2000 (53 155 veterans with and 127 938 veterans without PTSD).ĭuring the follow-up period between October 1, 2000, and December 31, 2007, 31 107 (17.2%) veterans were ascertained to have newly diagnosed dementia according to International Classification of Diseases, Ninth Revision, Clinical Modification codes. Posttraumatic stress disorder (PTSD) is highly prevalent among US veterans because of combat and may impair cognition. It seems reasonable to suppose that the knowledge of a patient´s mood, cognition, and behavior, along with applying careful consideration of the choice of the particular cardiovascular drug and respecting its potential psychological benefit or harm might improve the individualized approach to the treatment of cardiovascular disorders.
Statins and some beta-blockers appear to have an equivocal impact on mood and anxiety and ivabradine expressed neutral psychological impact. In general, beta-blockers, central sympatholytics, ACE inhibitors, ARBs, aldosterone receptor blockers, sacubitril/valsartan and fibrates are considered to exert anxiolytic effect in animal experiments and clinical setting.
In terms of this consideration, recognizing the potential of principal cardiovascular drugs to interact with the mental state in patients with heart or vasculature disturbances is unavoidable, in order to optimize their therapeutic benefit. Thus, it appears to be of utmost importance to examine the alteration of emotions, cognition, and behavior in cardiovascular patients. This results in circulus vitiosus potentiating mental and circulatory disorders. The pathophysiological background of this bidirectional interplay could reside in an inappropriate activation of vegetative neurohormonal and other humoral systems in both cardiovascular and psychological disturbances. On the other hand, deteriorating conditions of the heart and vasculature result in disturbed mental and emotional health. Undesirable emotions and behavior such as anxiety and depression, appear to participate in worsening cardiovascular pathologies. Besides the well-recognized risk factors, novel conditions increasing cardiovascular morbidity and mortality are emerging.
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