{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:47:08Z","timestamp":1790290028855,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,9,26]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">A cohort study found that 9\/11\u2010related environmental exposures and posttraumatic stress disorder increased self\u2010reported cardiovascular disease risk. We attempted to replicate these findings using objectively defined cardiovascular disease hospitalizations in the same cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Data for adult World Trade Center Health Registry enrollees residing in New York State on enrollment and no cardiovascular disease history (n=46\u00a0346) were linked to a New York State hospital discharge\u2013reporting system. Follow\u2010up began at Registry enrollment (2003\u20132004) and ended at the first cerebrovascular or heart disease (\n              <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\n              ) hospitalization, death, or December 31, 2010, whichever was earliest. We used proportional hazards models to estimate adjusted hazard ratios (\n              <jats:styled-content style=\"fixed-case\">AHR<\/jats:styled-content>\n              s) for\n              <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\n              (n=1151) and cerebrovascular disease (n=284) hospitalization during 302\u00a0742 person\u2010years of observation (mean follow\u2010up, 6.5\u00a0years per person), accounting for other factors including age, race\/ethnicity, smoking, and diabetes. An elevated risk of\n              <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\n              hospitalization was observed among women (\n              <jats:styled-content style=\"fixed-case\">AHR<\/jats:styled-content>\n              1.32, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.01 to 1.71) but not men (\n              <jats:styled-content style=\"fixed-case\">AHR<\/jats:styled-content>\n              1.16, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.97 to 1.40) with posttraumatic stress disorder at enrollment. A high overall level of World Trade Center rescue and recovery\u2013related exposure was associated with an elevated\n              <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\n              hospitalization risk in men (\n              <jats:styled-content style=\"fixed-case\">AHR<\/jats:styled-content>\n              1.82, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.06 to 3.13;\n              <jats:italic>P<\/jats:italic>\n              for trend=0.05), but findings in women were inconclusive (\n              <jats:styled-content style=\"fixed-case\">AHR<\/jats:styled-content>\n              3.29, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.85 to 12.69;\n              <jats:italic>P<\/jats:italic>\n              for trend=0.09). Similar associations were observed specifically with coronary artery disease hospitalization. Posttraumatic stress disorder increased the cerebrovascular disease hospitalization risk in men but not in women.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              9\/11\u2010related exposures and posttraumatic stress disorder appeared to increase the risk of subsequent hospitalization for\n              <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\n              and cerebrovascular disease. This is consistent with findings based on self\u2010reported outcomes.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.113.000431","type":"journal-article","created":{"date-parts":[[2013,10,25]],"date-time":"2013-10-25T06:27:55Z","timestamp":1382682475000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":82,"title":["Cardiovascular Disease Hospitalizations in Relation to Exposure to the September 11, 2001 World Trade Center Disaster and Posttraumatic Stress Disorder"],"prefix":"10.1161","volume":"2","author":[{"given":"Hannah T.","family":"Jordan","sequence":"first","affiliation":[{"name":"World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Queens, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Stellman","sequence":"additional","affiliation":[{"name":"World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Queens, NY"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Morabia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY"},{"name":"Barry Commoner Center for the Biology of Natural Systems, Queens CollegeCity University of New York,  New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Miller\u2010Archie","sequence":"additional","affiliation":[{"name":"World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Queens, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Alper","sequence":"additional","affiliation":[{"name":"Office of Health Care Access and Improvement, New York City Department of Health and Mental Hygiene, Queens, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoey","family":"Laskaris","sequence":"additional","affiliation":[{"name":"Barry Commoner Center for the Biology of Natural Systems, Queens CollegeCity University of New York,  New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Brackbill","sequence":"additional","affiliation":[{"name":"World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Queens, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Cone","sequence":"additional","affiliation":[{"name":"World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Queens, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60966-5"},{"key":"e_1_3_5_3_2","first-page":"1","article-title":"Surveillance for World Trade Center disaster health effects among survivors of collapsed and damaged buildings","volume":"55","author":"Brackbill RM","year":"2006","unstructured":"Brackbill RM, Thorpe LE, DiGrande L, Perrin M, Sapp JH, Wu D, Campolucci S, Walker DJ, Cone J, Pulliam P, Thalji L, Farfel MR, Thomas P. 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