Abstract
A growing body of literature on military personnel and veterans’ health suggests that prior military service may be associated with exposures that increase the risk of cardiovascular disease (CVD), which may differ by race/ethnicity. This study examined the hypothesis that differential telomere shortening, a measure of cellular aging, by race/ethnicity may explain prior findings of differential CVD risk in racial/ethnic groups with military service. Data from the first two continuous waves of the National Health and Nutrition Examination Survey (NHANES), administered from 1999–2002 were analyzed. Mean telomere length in base pairs was analyzed with multivariable adjusted linear regression with complex sample design, stratified by sex. The unadjusted mean telomere length was 225.8 base shorter for individuals with prior military service. The mean telomere length for men was 47.2 (95% CI: −92.9, −1.5; p < 0.05) base pairs shorter for men with military service after adjustment for demographic, socioeconomic, and behavioral variables, but did not differ significantly in women with and without prior military service. The interaction between military service and race/ethnicity was not significant for men or women. The results suggest that military service may contribute to accelerated aging as a result of health damaging exposures, such as combat, injury, and environmental contaminants, though other unmeasured confounders could also potentially explain the results.
Highlights
A growing body of literature suggests that United States (US) military veterans, especially those exposed to combat [3,4], have elevated risk of hypertension [4,5] and cardiovascular disease (CVD) [3,6,7]
The remaining amount of telomere shortening (47.2 base pairs) was equivalent to 3.3 years of additional aging, all other things being equal. These results suggest that, in men, significant residual telomere shortening is associated with prior military service, over and above variability explained by differences in demographic, socioeconomic, and behavioral profiles
While we did find that mean telomere length was significantly longer in non-Hispanic Black women compared to non-Hispanic White women, we found no evidence that prior military service was associated with shorter mean telomere length among women
Summary
A growing body of literature suggests that US military veterans, especially those exposed to combat [3,4], have elevated risk of hypertension [4,5] and CVD [3,6,7]. Military veterans may be at risk for CVD due to a variety of factors, including behavioral [8], and exposure to stressful environments, such as combat [3,4] and traumatic injury [6,9], leading to post-traumatic stress disorder (PTSD) [5,10,11,12] and depression [13,14]. Despite the fact that non-Hispanic Blacks in the US tend to have higher CVD risks than non-Hispanic Whites [15,16], a recent study
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