THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Wednesday, March 29, 1995 TAG: 9503290421
SECTION: FRONT PAGE: A1 EDITION: FINAL
SOURCE: BY BILL HENDRICK, COX NEWS SERVICE
LENGTH: Medium: 85 lines
Men who were held as prisoners by the Germans or Japanese in World War II are 8 1/2 times more likely than other combat veterans of that bloody conflict to suffer a stroke in their golden years, says a study in the March issue of the Primary Psychiatry journal.
This is a key finding, especially as the 50th anniversary of the war's end nears with most veterans in peak stroke years, said the study's author, Dr. Lawrence M. Brass, a well-known authority on strokes.
In another finding, with potential impact for Vietnam vets, Brass said he found that World War II POWs who suffered emotional problems at war's end or later - diagnosed as post-traumatic stress disorder - were much more likely than other former prisoners to suffer strokes.
Brass is chief of neurology at West Haven Veterans Affairs Medical Center in Connecticut and is a professor at the Yale University Medical School.
He and his colleagues studied records of 475 men who were prisoners during World War II, comparing them with a group of 80 veterans who'd served under similar circumstances but weren't captured.
More than 9 percent of the former POWs had a stroke up to 40 years later, compared to 1 percent of the other veterans.
``In other words, if you were a POW, your risk of having a stroke 40 years later was 8 1/2 times, or 850 percent higher, than a veteran of the same age who didn't get captured, served in the same branch of service and under similar circumstances,'' he said.
Brass, director of Yale's stroke program, said his study shows that prolonged stress may have vascular consequences, in addition to known psychiatric ones. And wartime stress can manifest itself years or decades later, he said.
In looking at WWII vets' records, he found no differences in the rates of hypertension, diabetes, high blood pressure, cigarette smoking or other traditional stroke risk factors. Though much has been learned about links between strokes and cardiovascular disease, little is known about the role of stress in stroke.
He obtained data from the National Academy of Sciences, which conducted follow-up medical examinations of World War II POWs. These included physical exams and psychiatric and neuropsychological testing.
With post-traumatic stress disorder, he found that almost 13 percent who suffered from it after the war eventually had a stroke, compared to nearly 8 percent who didn't suffer it.
This means thousands of Vietnam-era veterans who've had PTSD may be at a much greater risk of stroke in 20 or 30 years than others who served in that war.
Experience in war, Brass said, can ``be like resetting a thermostat'' that prevents a person from ever ``going back to normal.''
He looked at the WWII POWs because ``they had suffered an incredibly severe stress'' and because accurate and thorough medical records were available. He said the research may point to new therapies or drugs to help veterans or anyone deal with stress.
More research is needed, he said, to make sure that ``a few years of being a POW is worse than 40 years of a bad marriage,'' but the evidence strongly points to the conclusions that strokes, because they occurred more frequently among ex-POWs with post-traumatic stress disorder, ``are a manifestation of an inability to cope with stress.''
In the post-WWII era, ``so-called `real men' didn't discuss things like stress,'' Brass said, but the statistics suggest many ex-POWs paid the price later.
He said a research project, lasting several decades, should be conducted on Vietnam-era veterans.
``Vietnam veterans haven't gotten to the age yet where they are having strokes,'' he said. ``This study gives us an opportunity to step in and investigate a whole new area'' in stroke research.
He said American war veterans shouldn't become overly alarmed, ``but be sure you do what you can to reduce risks. If you have hypertension and PTSD, make sure your hypertension is controlled. I also would write my congressman demanding more research.'' ILLUSTRATION: Graphic
LOCAL POWS
The Department of Veterans Affairs has identified 262 former
prisoners of war living in Hampton Roads.
by CNB