{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:51:37Z","timestamp":1779195097990,"version":"3.51.4"},"reference-count":49,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"unspecified","delay-in-days":35,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2045796024000052_sec1a\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>Prior research, largely focused on US male veterans, indicates an increased risk of cardiovascular disease among individuals with post-traumatic stress disorder (PTSD). Data from other settings and populations are scarce. The objective of this study is to examine PTSD as a risk factor for incident major adverse cardiovascular events (MACEs) in South Africa.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796024000052_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>We analysed reimbursement claims (2011\u20132020) of a cohort of South African medical insurance scheme beneficiaries aged 18\u00a0years or older. We calculated adjusted hazard ratios (aHRs) for associations between PTSD and MACEs using Cox proportional hazard models and calculated the effect of PTSD on MACEs using longitudinal targeted maximum likelihood estimation.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796024000052_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>We followed 1,009,113 beneficiaries over a median of 3.0\u00a0years (IQR 1.1\u20136.0). During follow-up, 12,662 (1.3%) persons were diagnosed with PTSD and 39,255 (3.9%) had a MACE. After adjustment for sex, HIV status, age, population group, substance use disorders, psychotic disorders, major depressive disorder, sleep disorders and the use of antipsychotic medication, PTSD was associated with a 16% increase in the risk of MACEs (aHR 1.16, 95% confidence interval (CI) 1.05\u20131.28). The risk ratio for the effect of PTSD on MACEs decreased from 1.59 (95% CI 1.49\u20131.68) after 1\u00a0year of follow-up to 1.14 (95% CI 1.11\u20131.16) after 8\u00a0years of follow-up.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796024000052_sec4d\">\n\t    <jats:title>Conclusion<\/jats:title>\n\t    <jats:p>Our study provides empirical support for an increased risk of MACEs in males and females with PTSD from a general population sample in South Africa. These findings highlight the importance of monitoring cardiovascular risk among individuals diagnosed with PTSD.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s2045796024000052","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T09:32:43Z","timestamp":1707125563000},"source":"Crossref","is-referenced-by-count":9,"title":["Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: a cohort study of a South African medical insurance scheme"],"prefix":"10.1017","volume":"33","author":[{"given":"Cristina","family":"Mesa-Vieira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiane","family":"Didden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Schomaker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes P.","family":"Mouton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Folb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leigh L.","family":"van den Heuvel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Gastaldon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morna","family":"Cornell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mpho","family":"Tlali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reshma","family":"Kassanjee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar H.","family":"Franco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soraya","family":"Seedat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4849-181X","authenticated-orcid":false,"given":"Andreas D.","family":"Haas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"S2045796024000052_ref32","unstructured":"NDoH, STATS S, SAMRC and ICF (2019) South Africa Demographic and Health Survey 2016. 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