Sunday, March 10, 2013

Service Member Autopsies Are Helping Medical Researchers

James G. Fausone
Veteran Advocate

More than one out of every 12 U.S. service members who died during the Iraq and Afghanistan wars were found during autopsy to have early signs of heart disease. While none of the service members were diagnosed with heart disease prior to their deployments, all of them were found to have plaque buildup in the arteries around their hearts. How did such a young, fit group of people "pass" health screenings when they had early-stage heart disease?  Many heart diseases such as plaque build up are asymptomatic in the early stages, showing no sign of trouble down the road.

In the civilian population, according to the Centers for Disease Control and Prevention, heart disease accounts for roughly one-in-four deaths each year, or approximately 600,000 U.S. residents.  

Autopsies performed on service members who died in combat or from other injuries between 2001 and 2011 were originally done to give an accounting of how they died to their family members. The results were studied, not unlike research on autopsy results performed on vets from the Korean and Vietnam wars. Those studies found that as many as 75 percent of the vets had heart disease at the time of death. Those findings were considered critical in helping the medical community recognize that coronary disease could start at a younger age than previously thought, and stay "silent" or asymptomatic for longer than had previously been assumed.

The autopsy results for service members from the Vietnam and Korean wars are not considered directly comparable to that of the Iraq and Afghanistan service members, as researchers believe the draft may have affected the healthier versus less healthy individuals who enlisted voluntarily. Researchers also believe the lower number of service members found with heart disease is likely a strong indicator of a decline in heart disease throughout the U.S.

Researchers looked at more than 3,800 autopsies; 98 percent were men. Of the 9 percent who were found to have plaque buildup in their coronary arteries, roughly 25 percent were found to have severe blockage. Those who had been obese or had high blood pressure or high cholesterol when they began service were far more likely to have excessive plaque buildup. Researchers hypothesized that the lower percentage of heart disease they found was due in large part to improved, early treatment of high blood pressure and cholesterol as well as a drop in smoking among today's service members. Ongoing concerns for heart disease risk include obesity and diabetes, which researchers say still need to be addressed in our country.

Sources Journal of the American Medical Association, online December 25, 2012

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