Date of Award

8-23-2024

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Exercise Science

Advisor(s)

Kevin Heffernan

Second Advisor

Tiago Barreira

Keywords

Hypertension;Military;Veterans

Abstract

Military veterans may be at increased risk over non-veterans for the development of hypertension, potentially due to the consequences of their unique military stressors; however, research has not consistently shown this. We sought to interrogate nationwide datasets to determine the impact of different military service experiences on the risk for hypertension diagnosis and explore the impact of military occupational stressors on hypertension risk factors via the Behavioral Risk Factor Surveillance System (BRFSS) and National Health Interview Survey (NHIS). Study 1 assessed hypertension diagnoses in the context of combat exposure and the presence of psychiatric disorders (PD) and/or traumatic brain injury (TBI) (2011 BRFSS). Veterans with PD and/or TBI were found to have greater odds of hypertension diagnosis than combat and non-combat veterans without PD/TBI, but odds did not differ from non-veterans. Study 2 examined service-connected disability (SCD) and hypertension diagnoses (2022 NHIS). The odds of being diagnosed with hypertension were greater in veterans compared with non-veterans; however, hypertension diagnosis odds were not different after controlling for mental health disorders. Study 3 explored age-related changes (in cohorts aged 19 to 85 years) in moderate-to-vigorous physical activity (MVPA) (2011-2018 NHIS). We noted that veteran men accrued more MVPA than non-veteran men at younger ages, whereas after 65 years of age veterans obtained less MVPA than non-veterans. In contrast, veteran women obtained more MVPA than non-veterans at all ages. These studies suggest that psychosocial and cerebrovascular health may contribute to hypertension diagnoses in military veterans. Additionally, older veteran men may have increased risk for the future development of hypertension due to greater reductions in MVPA with advancing age.

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Open Access

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