Article

Data Trends 2022: Cardiovascular Diseases

The VHA utilizes health records of its members for its own research needs and for others. For cardiology researchers, having millions of electronic health records at their disposal provides more details on the role genetics play in hypertension and how people with atrial fibrillation and heart failure should choose their anticoagulants.

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  • In veterans with history of deployment, combat exposure and injury are associated with increased risk for hypertension.1

  • Other factors associated with hypertension1

  • Racial disparities in hypertension exist with African Americans having a higher hypertension prevalence compared to non-Hispanic Whites and Hispanics. A study of more than 300,000 veterans demonstrated that genetic ancestry is a risk factor for hypertension beyond race and ethnicity.2-4

  • British and Scottish ancestry was more protective against treatment-resistant hypertension across all races and ethnicities, while Nigerian ancestry was associated with an increased risk.4

  • 5% of veterans treated in the VA have chronic heart failure, which is closely linked with CKD.5,6

  • In veterans with CKD, iron levels were inversely associated with risk for heart failure hospitalization.6

  • Patients with heart failure commonly have poor kidney function and an indication for anticoagulation. Direct oral anticoagulants (DOACs) are processed through the kidneys. A study of nearly 50,000 veterans with heart failure and atrial fibrillation showed that, in fact, DOACs were associated with less bleeding and death compared to a vitamin K antagonist.7

  • A population of younger active-duty service members meets retention standards despite having a diagnosis of atrial fibrillation. A retrospective analysis of personnel treated within the San Antonio Military Health System between 2004 and 2019 examined the characteristics of these patients.8

  • A study of 400,000+ veterans over the age of 55 with newly diagnosed atrial fibrillation showed that AF increases risk of dementia. There is a risk of dementia in patients who are being treated with anticoagulants. Patients with other cardiovascular comorbidities in addition to atrial fibrillation are also at an increased risk for dementia.9

  • Frailty defines a person’s capacity to withstand an adverse event; over time, this lack of strength affects all bodily functions. A study of 3 million veterans found that the presence and severity of frailty* increases the risk of stroke, myocardial infarction (MI), and death from a cardiovascular event.10

  • Risk of MI or death from MI was most greatly associated with frailty, with trends across all cardiovascular outcomes remaining similar between 2002 and 2014. Ranges represent the highest and lowest hazard ratios observed during this period.10


 

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