Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, North Carolina.
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, North Carolina.
Womens Health Issues. 2017 Nov-Dec;27(6):700-706. doi: 10.1016/j.whi.2017.08.002. Epub 2017 Sep 8.
Women veterans are at increased risk for cardiovascular disease (CVD), but little is known about comorbidities and healthcare preferences associated with CVD risk in this population.
We describe the prevalence of CVD-relevant health behaviors, mental health symptoms, and health care use characteristics and preferences among participants of the National Survey of Women Veterans (conducted 2008-2009).
Fifty-four percent of respondents were at risk for CVD (defined as a diagnosis of hypertension, diabetes, current tobacco use, or obesity without CVD). In unadjusted analysis, ORs for being at risk for CVD were greater among those interested in gender-specific clinical settings (OR, 2.0; 95% CI, 1.2-3.4) and gender-specific weight loss programs (OR, 1.8; 95% CI, 1.1-2.9). ORs were also greater for women who were physically inactive (OR, 1.9; 95% CI, 1.1-3.3), with current symptoms of depression (OR, 2.5; 95% CI, 1.1-6.1), anxiety (OR, 2.1; 95% CI, 1.2-3.6), and posttraumatic stress disorder (OR, 2.4; 95% CI, 1.2-4.8). Adjusting for age, race/ethnicity, marital status, education level, employment, and source of health care use, the ORs for CVD risk were higher for women with current posttraumatic stress disorder symptoms (2.5; 95% CI, 1.1-5.3) and gender-specific health care preferences (2.0; 95% CI, 1.1-3.4), and gender-specific weight loss programs (1.9; 95% CI, 1.1-3.2).
Risk for CVD was common and preferences for gender-specific care and posttraumatic stress disorder were associated with being at risk for CVD. Women's health clinics may be a good location for targeted CVD prevention interventions for women veterans both in and outside the Veterans Health Administration.
女性退伍军人患心血管疾病（CVD）的风险增加，但对于这一人群中与 CVD 风险相关的合并症和医疗保健偏好知之甚少。
我们描述了参与全国女性退伍军人调查（2008-2009 年进行）的参与者中与 CVD 相关的健康行为、心理健康症状和医疗保健使用特征和偏好的流行情况。
54%的受访者有 CVD 风险（定义为患有高血压、糖尿病、当前吸烟或肥胖但无 CVD）。在未调整的分析中，对性别特定临床环境（比值比，2.0；95%置信区间，1.2-3.4）和性别特定减肥计划（比值比，1.8；95%置信区间，1.1-2.9）感兴趣的人患 CVD 的风险更高。身体活动不足（比值比，1.9；95%置信区间，1.1-3.3）、当前有抑郁症状（比值比，2.5；95%置信区间，1.1-6.1）、焦虑（比值比，2.1；95%置信区间，1.2-3.6）和创伤后应激障碍（比值比，2.4；95%置信区间，1.2-4.8）的女性患 CVD 的风险更高。调整年龄、种族/民族、婚姻状况、教育程度、就业和医疗保健使用来源后，当前创伤后应激障碍症状（比值比，2.5；95%置信区间，1.1-5.3）和性别特定医疗保健偏好（比值比，2.0；95%置信区间，1.1-3.4）以及性别特定减肥计划（比值比，1.9；95%置信区间，1.1-3.2）的女性患 CVD 的风险更高。
CVD 风险很常见，对性别特定护理和创伤后应激障碍的偏好与 CVD 风险相关。妇女健康诊所可能是退伍军人事务部内外针对女性退伍军人进行有针对性的 CVD 预防干预的理想场所。
