More scientists worry that mental illnesses from war, such as post-traumatic stress disorder, can damage the body as much as the emotions. Some even speculate that war could cause an early aging affect.
It means the cost of war can last decades beyond the battles are fought.
An unusual study released today underscores these fears. During 13 years of research, scientists followed twins who were Vietnam-era veterans -- 340 identical and 222 fraternal -- and found that those with PTSD were more than twice as likely to develop coronary heart disease.
The findings were published today in the Journal of the American College of Cardiology.
"This study provides further evidence that PTSD may affect physical health," says Gary Gibbons, director of the National Heart, Lung and Blood Institute, part of the National Institutes of Health, which provided some funding for the research.
Scientists at the Emory University Rollins School of Public Health followed Vietnam-era veterans, about half of whom had served in Southeast Asia. By using the 562 twins, researchers were able to control for genetic or environmental influences in the development of heart disease and PTSD.
Heart disease was found among 22.6% of veterans with PTSD compared with 8.9% without the mental illness.
Studies show that about 10% to 12% of troops who served in the Iraq and Afghanistan wars suffer from PTSD, often characterized as a signature wound of those conflicts.
Scientists speculate that because the mental disorder causes high rates of anxiety, it can lead to heart-damaging higher blood pressure and heart rates.
Heart disease in this study was defined as suffering a heart attack, being hospitalized overnight with a heart-related problems or having undergone a heart operation.
Scientists with the Department of Veterans Affairs tracking veterans who served in Iraq and Afghanistan and who have been diagnosed with PTSD and mild traumatic brain injury also report finding signs of heart disease, diabetes, slowed metabolism and obesity among young veterans -- maladies more common to middle age and beyond.