A large, independent analysis of national health registries in Denmark examined psychiatric diagnoses that appeared within three years after a traumatic event and their association with later cardiovascular outcomes. The study cohort included 219,866 adults between 1995 and 2019. Over the 24-year period, 43,994 participants experienced a non-fatal heart attack, non-fatal stroke, a procedure to restore blood flow to the heart, or cardiovascular death. Using machine learning to rank predictors, the investigators found that alcohol abuse was the most important posttraumatic psychiatric predictor of serious cardiovascular events for both men and women. Mood disorders, including depression, were also strong predictors and were more prominent among women. Additional psychiatric diagnoses linked to increased cardiovascular risk included PTSD, other substance use disorders, personality disorders, schizophrenia, bipolar disorder, anxiety disorders, non-substance-induced confusion, and mental disorders due to brain or physical causes.
Researchers used Denmark’s national health registries to identify adults aged 18 and older who experienced traumatic events and tracked psychiatric diagnoses appearing within three years after the trauma. The analytic sample totaled 219,866 adults from 1995 through 2019. Of these, 43,994 experienced the cardiovascular outcomes of interest during the study period. The investigators compared 175,872 trauma-exposed individuals who did not have a cardiovascular event to those who did. Outcomes assessed separately included non-fatal heart attack, non-fatal stroke, procedures to restore coronary blood flow (revascularization), and cardiovascular death. Machine learning methods were applied to consider a wide range of posttraumatic mental health diagnoses and identify the 15 most important predictors of later heart and brain outcomes.
The analysis identified multiple psychiatric conditions arising after trauma that were associated with higher subsequent cardiovascular risk. The single strongest predictor across sexes was alcohol abuse. Mood disorders, such as depression, were also prominent predictors for both men and women. Other posttraumatic psychiatric conditions associated with increased cardiovascular risk included PTSD, substance use disorders beyond alcohol, personality disorders, schizophrenia, bipolar disorder, anxiety disorders, mental disorders stemming from brain or physical conditions, and episodes of non-substance-induced confusion. The study ranked these conditions by importance using machine learning; the source reports the rank order finding for alcohol abuse and the prominence of mood disorders but does not provide the full ranked list in the news release.
While alcohol abuse was the top predictor for both men and women, the study highlights sex differences in the relative importance of other conditions. Mood disorders (for example, depression) were more prominent predictors among women than men. The news release emphasizes that mood disorders were strong indicators for cardiovascular outcomes in both sexes, but they contributed more to risk classification in female participants.
Authors and external experts emphasize that traumatic events are common and can lead to diverse mental health consequences that may affect cardiovascular health. Lead author Jennifer A. Sumner, Ph.D., noted that work focused solely on PTSD may miss other posttraumatic psychiatric conditions that also signal higher cardiovascular risk. The findings underscore the need to recognize and treat a broad range of psychiatric disorders after trauma. An external commentator, Glenn N. Levine, M.D., FAHA, stated that recognizing trauma, seeking mental health support, and managing cardiovascular risk factors may help mitigate long-term cardiovascular risk. The authors suggest that treating psychiatric conditions arising after trauma could have positive effects on both mental and cardiovascular health over the long term.
The research used Danish national health data; Denmark’s universal, free health-care system may limit applicability of results to populations in other countries or regions. The news release explicitly states the study did not examine mechanistic explanations for why posttraumatic mental disorders are associated with higher cardiovascular risk. The source does not report effect sizes, hazard ratios, confidence intervals, or the complete ranked list of the 15 predictors in the news release summary. Co-authors, disclosures and funding sources are reported in the manuscript itself.
Additional resources and related American Heart Association materials are listed in the release. The peer-reviewed manuscript was published in the Journal of the American Heart Association; the news release provides a DOI link to the article for readers seeking full methods, statistical results, co-author and funding details. The release also references prior AHA statements and news about psychological distress and cardiovascular outcomes.