War Trauma Factors and Cardiovascular Risk

One of the major risk factors that may promote atherogenesis is chronic stress. War and its consequences are powerful stress factors. Wars fought all over the world have changed global life conditions. A war is a mass disaster with several effects (death, injury, loss of close persons, exposure to various tortures, home eviction, exile, rapid impoverishment, social uncertainty) that brings tremendous suffering to the population affected. Stress causes increased concentrations of catecholamine and corticosteroid hormones in blood, which may lead to atherosclerosis and hypertension. On the behavioral side, stress is associated with smoking and alcohol abuse, which favors the development of cardiovascular disease. According to these indicators, we can see that chronic stress can promote all other factors of atherogenesis (hypertension, lipid metabolism, smoking, obesity due to improper diet and inadequate physical activity). Finally, increased cardiac mortality has been associated with the stress from war, particular from post-traumatic stress disorder. Further studies and possibly clinical trials to intervene on persons with war stress are warranted to best identify those at highest risk where intervention may be helpful to reduce subsequent cardiovascular events.