Trends of ischemic heart disease and cerebrovascular disease in active component female service members, 2014-2023

Abstract: This study summarizes trends from 2014 through 2023 in the incidence of ischemic heart disease and cerebrovascular heart disease among U.S. active component female service members and identifies potential military-specific risk factors for these conditions. Female-specific risk factors, such as mental health, for ischemic heart and cerebrovascular diseases have only recently been recognized. Crude incidence rates were assessed for each outcome and Poisson regression was used to calculate adjusted incidence rates, controlling for multiple covariates. After adjustment, non-Hispanic Black active component U.S. service women had higher rates for both ischemic heart disease and cerebrovascular disease compared to non-Hispanic White service women (IRR=1.68 and 1.24, respectively). A prior diagnosis of depressive or anxiety disorder resulted in a 90% increased rate of ischemic heart disease and 70% increased rate of cerebrovascular disease. Air Force members had a 55% increased rate of ischemic heart disease. This study identifies both military-specific and demographic risk factors for these 2 cardiovascular diseases and demonstrates potential opportunity for early age preventive care, even among a relatively young and healthy population. Among active component U.S. service women, incidence of ischemic heart disease increased between 2014 (31.2 per 100,000 person-years) and 2019 (54.7 per 100,000 p-yrs), while incidence of cerebrovascular disease decreased during that period and increased between 2019 (28.5 per 100,000 p-yrs) and 2023 (46.4 per 100,000 p-yrs). Older age, non-Hispanic Black race and ethnicity, and prior depressive or anxiety disorder diagnosis were identified as potential risk factors for both outcomes.