# Association of PTSD dose with cardiovascular disease risk in multi-ethnic WTC Heart Cohort: 13 year follow up

> **NIH ALLCDC U01** · QUEENS COLLEGE · 2022 · $599,251

## Abstract

Background: Treatment of post-traumatic stress disorder (PTSD) may help prevent cardiovascular diseases (CVD,)
which is a leading cause of death. Randomized controlled trials comparing the effect of PTSD treatment vs. placebo
on CVD risk would be unable to assess the relation of duration of PTSD symptoms (“dose”) to CVD risk (e.g., CHD
morbidity and mortality) rather than pathophysiological markers, given the duration of study and sample size
needed. Here, we propose to collect data to complement the results of the ideal trial – that is, to use observational
data appropriately and efficiently – by making use of our longitudinal study tracking the time-varying symptoms of
PTSD, time-varying conventional CVD risk factors and, as outcome, incidence and mortality from CVD. The multi-
ethnic WTC-Heart cohort study will be accompanied by a sub-study assessing whether, as assumed, individuals with
lower PTSD dose have lower exposure to markers of stress, trauma, and CVD risk factors. Preliminary work: 1. A
cohort study of initially 6481 first responders with a long term follow up and high retention rate: In 2012-2013
WTC-Heart enrolled 6481 first-responders in the WTC Health Program (WTCHP) to assess the determinants of
incident cases of CVD reported by cohort members and validated in medical charts, and incident hospitalizations
from the NY State hospitalization registry (SPARCS). Retention was 91% as of 2016. 2. Longitudinal assessment of
PSTD symptoms and conventional CVD risk factors: The cohort members have had up to 15 visits at the WTCHP in
which mental health and CVD factors were assessed. 3. A diverse gender and race/ethnic composition: the cohort
comprises 17% of women and 54% Non-Hispanic Whites. Specific Aims: Aim 1. To perform a second in-person,
standardized assessment in 2022-23 of the WTC-Heart cohort with follow-up until 2026, taking advantage of the
statistical power resulting from 13-14 years of follow-up, high prevalence of PTSD, linkage with National Death
Index. Aim 2. To estimate the causal effect of PTSD dose and its potential changes on total (fatal and non-fatal) and
non-fatal CVD, coronary artery disease, and cerebrovascular diseases, overall and among ethnic (non-Hispanic white,
non-Hispanic Black, and Hispanic) groups. Analyses will use repeated assessments of PTSD and CVD between 2012
and 2026, and appropriate adjustment for time-updating CVD risk factors, and for COVID-19 exposure, using G-
methods. Aim 3. To assess the biological, behavioral and trauma history plausibility of the epidemiological
associations between PTSD dose and CVD risk by measuring biological indicators of chronic stress, history of trauma,
and CVD risk factor among a subsample of 240 participants randomly recruited within tertiles of PTSD dose.
Innovation and Significance: The proposed study has a potentially major clinical and public health significance if it
helps to determine whether: 1) risk of CVD morbidity and mortality is inversely related to P...

## Key facts

- **NIH application ID:** 10535549
- **Project number:** 1U01OH012265-01A1
- **Recipient organization:** QUEENS COLLEGE
- **Principal Investigator:** Alfredo Morabia
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2022
- **Award amount:** $599,251
- **Award type:** 1
- **Project period:** 2022-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10535549

## Citation

> US National Institutes of Health, RePORTER application 10535549, Association of PTSD dose with cardiovascular disease risk in multi-ethnic WTC Heart Cohort: 13 year follow up (1U01OH012265-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10535549. Licensed CC0.

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