{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:49:42Z","timestamp":1787068182810,"version":"build-2736575974"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,10,3]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Approximately 30% of the 700\u2009000 Gulf War veterans report a chronic symptom\u2010based illness of varying severity referred to as Gulf War illness (GWI). Toxic deployment\u2010related exposures have been implicated in the cause of GWI, some of which contribute to metabolic dysregulation and lipid abnormalities. As this cohort ages, the relationship between GWI and atherosclerotic cardiovascular disease (ASCVD) is a growing concern.<\/jats:p>\n                    <jats:p xml:lang=\"en\">We evaluated associations between GWI and ASCVD, diabetes, hyperlipidemia, and hypertension in veterans of the Gulf War (1990\u20131991).<\/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\">Analysis of survey data collected in 2014 to 2016 from a national sample of deployed Gulf War veterans (n=942) and Veterans Health Administration electronic health record data (n=669). Multivariable logistic regression models tested for associations of GWI with self\u2010reported ASCVD, diabetes, hyperlipidemia, and hypertension, controlling for confounding factors. Separate models tested for GWI associations with ASCVD and risk factors documented in the electronic health record.<\/jats:p>\n                    <jats:p xml:lang=\"en\">GWI was associated with self\u2010reported hypertension (adjusted odds ratio [aOR], 1.67 [95% CI, 1.18\u20132.36]), hyperlipidemia (aOR, 1.46 [95% CI, 1.03\u20132.05]), and ASCVD (aOR, 2.65 [95% CI, 1.56\u20134.51]). In the subset of veterans with electronic health record data, GWI was associated with documented diabetes (aOR, 2.34 [95% CI, 1.43\u20133.82]) and hypertension (aOR, 2.84 [95% CI, 1.92\u20134.20]). Hyperlipidemia and hypertension served as partial mediators of the association between GWI and self\u2010reported ASCVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Gulf War veterans with GWI had higher odds of hyperlipidemia, hypertension, diabetes, and ASCVD compared with Gulf War veterans without GWI. Further examination of the mechanisms underlying this association, including a possible shared exposure\u2010related mechanism, is necessary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.029575","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T06:23:36Z","timestamp":1695968616000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Association of Atherosclerotic Cardiovascular Disease, Hypertension, Diabetes, and Hyperlipidemia With Gulf War Illness Among Gulf War Veterans"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5495-545X","authenticated-orcid":false,"given":"Sarah T.","family":"Ahmed","sequence":"first","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center Houston TX"},{"name":"Section of Health Services Research, Department of Medicine Baylor College of Medicine Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3595-4392","authenticated-orcid":false,"given":"Ruosha","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Sciences, School of Public Health The University of Texas Health Science Center at Houston Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6810-0249","authenticated-orcid":false,"given":"Peter","family":"Richardson","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center Houston TX"},{"name":"Section of Health Services Research, Department of Medicine Baylor College of Medicine Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurendro","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center Houston TX"},{"name":"Section of Health Services Research, Department of Medicine Baylor College of Medicine Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4940-069X","authenticated-orcid":false,"given":"Lea","family":"Steele","sequence":"additional","affiliation":[{"name":"Yudofsky Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences Baylor College of Medicine Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna L.","family":"White","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center Houston TX"},{"name":"Section of Health Services Research, Department of Medicine Baylor College of Medicine Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Nono","family":"Djotsa","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center Houston TX"},{"name":"Section of Health Services Research, Department of Medicine Baylor College of Medicine Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie","family":"Sims","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Epidemiology Center\u2013Durham, Durham VA Medical Center Durham VA Health Care System Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1488-0286","authenticated-orcid":false,"given":"Elizabeth","family":"Gifford","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Epidemiology Center\u2013Durham, Durham VA Medical Center Durham VA Health Care System Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Hauser","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Epidemiology Center\u2013Durham, Durham VA Medical Center Durham VA Health Care System Durham NC"},{"name":"Duke Molecular Physiology Institute and Department of Biostatistics and Bioinformatics Duke University Medical Center Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9541-6954","authenticated-orcid":false,"given":"Salim S.","family":"Virani","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety Michael E. 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