Abstract TMP56: Comparison of Incident Stroke in Veterans and Non-Veterans in a National Cohort

Abstract

Introduction: Veterans represent a unique population who may be at higher risk of stroke. However, the association between veteran status and stroke remains poorly defined. Methods: Veteran status was determined among 12,932 participants in the REasons for Geographic and Racial Differences in Stroke Study, a national population-based cohort. Demographics, socioeconomic (SE) factors, and vascular risk factors including Framingham Stroke Risk Score (FSRS) were compared between veterans and non-veterans. Veterans were further characterized as enlisted or commissioned officers. Hazard ratios for incident stroke were calculated for male and female veterans. Results: In this cohort, 3,405 veterans were identified. After adjusting for age, race, geographic region, income, and education, there were no substantial differences in vascular risk factors and FSRS between veterans and non-veterans other than a higher proportion of current smokers in male veterans (particularly enlisted) than non-veterans. Among those free of stroke at baseline, male veterans were at similar risk for incident stroke compared to non-veterans (Figure 1a), even with adjustment for age, race, SE factors, and vascular risk factors (HR 1.10, 95% CI 0.82-1.47). Female veterans were at an increased risk for incident stroke (Figure 1b, HR 2.30, 95% CI 1.21-4.34), although this difference was not significant when adjusted for SE and vascular risk factors. Risk for incident stroke was similar between enlisted and commissioned officers (Figure 1c,d). Conclusions: This is the one of the first studies to examine incident stroke among veterans and is not limited to those seeking care within the Veterans Health Administration. From this national cohort, military exposure did not increase the risk of incident stroke among males. Female veterans seem to be at a higher risk for incident stroke; however, this association was primarily driven by differences in vascular risk factors compared to non-veterans.