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Multiple constituents of smoke are associated with increased risk for atherosclerotic cardiovascular diseases (ASCVD), and other toxic exposures have been associated with autonomic and lipid dysfunction. We used data from the Gulf War Era Cohort and Biorepository Study of veterans deployed to Gulf War in 1990\u20131991 (<jats:italic>n<\/jats:italic>\u2009=\u2009942). We evaluated the association of deployment exposures (no, yes (1\u20136\u00a0days), (7\u201330\u00a0days), (31\u2009+\u2009days), and not sure) with clinical risk factors (hypertension, diabetes, high cholesterol) and ASCVD using multivariable logistic regression. We adjusted for all clinical risk factors in the models to test the association of military exposures and ASCVD. We found that 7\u201330\u00a0days exposure to oil well fire smoke (OR: 2.95, CI: 1.40, 6.19), PB pills (OR: 2.37, CI: 1.06, 5.32), and chemical\/biological agents (OR: 3.60, CI: 1.04, 12.51) were associated with ASCVD. Exposure to chemical\/biological agents for 7\u201330\u00a0days was also associated with hypertension (OR: 4.18, CI: 1.48, 11.86) and for 31\u2009+\u2009days was associated with ASCVD (OR: 4.24, CI:1.20, 14.94). The associations between oil well fire smoke and chemical\/biological agents with ASCVD remained significant in models adjusting for clinical risk factors. For GWVs, exposure to oil well fire smoke, chemical\/biological agents, and PB pills were associated with ASCVD. These exposures may represent population-specific risk enhancers for ASCVD and may be considered in individualized clinical risk assessment.<\/jats:p>","DOI":"10.1007\/s12012-025-10013-7","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T09:58:43Z","timestamp":1751709523000},"page":"1263-1271","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Atherosclerotic Cardiovascular Disease in Gulf War Veterans in Relation to Deployment Exposures"],"prefix":"10.1007","volume":"25","author":[{"given":"Sarah T.","family":"Ahmed","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruosha","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Steele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kellie","family":"Sims","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Quaden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly M.","family":"Harrington","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijay","family":"Nambi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Gaziano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George L.","family":"Delclos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Drew A.","family":"Helmer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,5]]},"reference":[{"issue":"10","key":"10013_CR1","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1093\/aje\/152.10.992","volume":"152","author":"L Steele","year":"2000","unstructured":"Steele, L. (2000). Prevalence and patterns of Gulf War illness in Kansas veterans: Association of symptoms with characteristics of person, place, and time of military service. American Journal of Epidemiology, 152(10), 992\u20131002. https:\/\/doi.org\/10.1093\/aje\/152.10.992","journal-title":"American Journal of Epidemiology"},{"issue":"11","key":"10013_CR2","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1001\/jama.280.11.981","volume":"280","author":"K Fukuda","year":"1998","unstructured":"Fukuda, K., Nisenbaum, R., Stewart, G., Thompson, W. W., Robin, L., Washko, R. M., Noah, D. L., Barrett, D. H., Randall, B., Herwaldt, B. L., Mawle, A. C., & Reeves, W. C. (1998). Chronic multisymptom illness affecting air force veterans of the Gulf War. 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Dr. Nambi reports stock options in Insera Therapeutics, research support from Abbott Labs, and site co-investigator role on a study sponsored by Ionis. The remaining authors have nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interest"}}]}}