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Sex Differences in Cardiovascular Disease Outcomes After Traumatic Brain Injury.

John E Balke1, Ian J Stewart2, Megan E Amuan3

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Traumatic brain injury (TBI) increases cardiovascular disease (CVD) risk. This risk is disproportionately higher in women veterans compared to men, highlighting a critical need for sex-specific care strategies.

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Area of Science:

  • Neuroscience
  • Cardiology
  • Military Health

Background:

  • Traumatic brain injury (TBI) is linked to increased cardiovascular disease (CVD) risk in service members and veterans.
  • Emerging evidence suggests sex-based differences in TBI outcomes.

Purpose of the Study:

  • To investigate and describe the risk of CVD after TBI, stratified by sex.
  • To compare CVD risk between men and women following TBI.

Main Methods:

  • Utilized data from the Long-term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium Phenotype study.
  • Analyzed CVD risk (coronary artery disease, stroke, peripheral artery disease, CVD mortality) using Fine-Gray competing risks models.
  • Stratified cohort into men and women to assess TBI severity and its association with subsequent CVD.

Main Results:

  • The cohort comprised over 1.2 million men and 282,000 women; TBI prevalence was 20.8% in men and 12.7% in women.
  • CVD was more prevalent in men (3.1%) than women (1.9%), despite men having more CVD risk factors.
  • Women experienced a larger increased risk of CVD across all TBI severities compared to men.

Conclusions:

  • While CVD is less common in women, TBI is associated with a significantly greater subsequent CVD risk in women.
  • Further research is essential to understand the underlying causes of this sex-specific association.
  • Findings are critical for improving long-term care for female service members, given their increasing combat roles.