Department of Defense Joint Trauma System, Defense Health Agency, Joint Base San Antonio-Fort Sam, Houston.
Department of Kinesiology, Health and Nutrition, University of Texas at San Antonio, San Antonio, Texas.
J Hypertens. 2020 Jul;38(7):1293-1301. doi: 10.1097/HJH.0000000000002364.
Although the long-term effects of combat injury are not well understood, there is emerging concern that exposure to combat environments and subsequent injury may increase the risk of hypertension through changes in inflammatory responses, psychological stress and mental health, and health behaviors.
Data from the Millennium Cohort Study and the Department of Defense Trauma Registry were used to identify combat-exposed and combat-injured participants. Incident hypertension diagnoses were ascertained from the Millennium Cohort survey. The associations between combat exposure/injury and hypertension risk was estimated using multivariable complementary log-log survival models.
The final analysis sample consisted of 38 734 participants. Of these, 50.8% deployed but were not exposed to combat, 48.6% deployed and were exposed to combat, and 0.6% had combat injury. Overall prevalence of hypertension was 7.6%. Compared with participants who deployed but did not experience combat (mild exposure), elevated odds of hypertension were observed among those who experienced combat but not wounded (moderate exposure; AOR, 1.28; 95% CI, 1.19-1.38) and those wounded in combat (high exposure; AOR, 1.46; 95% CI, 1.07-2.00). Sleep duration of less than 4 h (AOR, 1.21; 95% CI, 1.03-1.43), sleep duration of 4-6 h (AOR, 1.16; 95% CI, 1.05-1.29), posttraumatic stress disorder (AOR, 1.54; 95% CI, 1.26-1.87), and overweight (AOR, 1.77; 95% CI, 1.61-1.95) and obese (AOR, 2.77; 95% CI, 2.45-3.12) status were also associated with higher odds of hypertension.
Results support the hypotheses that combat exposure increases hypertension risk and that combat injury exacerbates this risk.
尽管人们对战斗伤害的长期影响还不甚了解，但人们越来越担心，暴露于战斗环境以及随后的伤害可能会通过改变炎症反应、心理压力和心理健康以及健康行为来增加患高血压的风险。
本研究使用千禧年队列研究和国防部创伤登记处的数据来确定经历过战斗和战斗受伤的参与者。从千禧年队列调查中确定高血压的新发诊断。使用多变量互补对数 - 对数生存模型来估计战斗暴露/伤害与高血压风险之间的关联。
最终分析样本包括 38734 名参与者。其中，50.8%的人部署但未暴露于战斗中，48.6%的人部署并暴露于战斗中，0.6%的人有战斗伤害。高血压的总体患病率为 7.6%。与未经历战斗（轻度暴露）的参与者相比，经历战斗但未受伤（中度暴露；优势比，1.28；95%置信区间，1.19-1.38）和在战斗中受伤（高度暴露；优势比，1.46；95%置信区间，1.07-2.00）的参与者发生高血压的几率更高。睡眠时间少于 4 小时（优势比，1.21；95%置信区间，1.03-1.43）、睡眠时间 4-6 小时（优势比，1.16；95%置信区间，1.05-1.29）、创伤后应激障碍（优势比，1.54；95%置信区间，1.26-1.87）以及超重（优势比，1.77；95%置信区间，1.61-1.95）和肥胖（优势比，2.77；95%置信区间，2.45-3.12）也与高血压的几率增加相关。
结果支持以下假设：战斗暴露会增加患高血压的风险，而战斗伤害会加剧这种风险。
