Terrorism, Acute Stress, and Cardiovascular Health: A 3-Year National Study Following the September 11th Attacks
Open accessAbstract
Context The terrorist attacks of 9/11 (September 11, 2001) present an unusual opportunity to examine prospectively the physical health impact of extreme stress in a national sample. Objective To examine the degree to which acute stress reactions to the 9/11 terrorist attacks predict cardiovascular outcomes in a national probability sample over the subsequent 3 years. Design, setting, and participants A national probability sample of 2729 adults (78.1% participation rate), 95.0% of whom had completed a health survey before 9/11 (final health sample, 2592), completed a Web-based assessment of acute stress responses approximately 9 to 14 days after the terrorist attacks. Follow-up health surveys reassessed physician-diagnosed cardiovascular ailments 1 (n = 1923, 84.3% participation rate), 2 (n = 1576, 74.2% participation rate), and 3 (n = 1950, 78.9% participation rate) years following the attacks. Main outcome measures Reports of physician-diagnosed cardiovascular ailments over the 3 years following the attacks. Results Acute stress responses to the 9/11 attacks were associated with a 53% increased incidence of cardiovascular ailments over the 3 subsequent years, even after adjusting for pre-9/11 cardiovascular and mental health status, degree of exposure to the attacks, cardiovascular risk factors (ie, smoking, body mass index, and number of endocrine ailments), total number of physical health ailments, somatization, and demographics. Individuals reporting high levels of acute…
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Cumulative exposure to daily stressors and exposure to traumatic stress can increase the risk of CVD.
“Studies have demonstrated that both cumulative exposure to daily stressors and exposure to traumatic stress can increase the risk of CVD. 15-17”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [15]
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- Authors
- Holman, E. A., Silver, R. C., Poulin, M., Andersen, J., Gil-Rivas, V., & McIntosh, D. N.
- Affiliations
- University of California, Irvine (US)
- University of Michigan (US)
- Syracuse VA Medical Center (US)
- University of Denver (US)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2008-01-01
- Volume
- 65
- Issue
- 1
- Pages
- 73
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2100623574
- Cited by
- 233
- References
- 5
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 9 · 2023: 11 · 2022: 10 · 2021: 2 · 2020: 12 · 2019: 7 · 2018: 11 · 2017: 50 · 2016: 7 · 2015: 6 · 2014: 8 · 2013: 20 · 2012: 7
- FWCI
- 14.74
- Type
- journal article
- Language
- en
- Open access
- green
- escholarship.org
- Licence
- cc-by
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Takotsubo Cardiomyopathy and Associated Phenomena
- Keywords
- September 11 attacks, acute stress, cardiovascular disease, hypertension, heart disease, post-traumatic stress, cardiovascular risk factors, somatization, body mass index, endocrine disorders, somatic comorbidity
- MeSH terms
- Adult, Cardiovascular Diseases, Female, Follow-Up Studies, Health Surveys, Humans, Male, Middle Aged, Stress, Psychological, United States, Terrorism, September 11 Terrorist Attacks
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