Danish Registry Study Links Post-Trauma Alcohol Use Disorder to Highest Cardiovascular Event Risk in Both Sexes

Researchers analyzed Danish national health registries for adults with and without new psychiatric diagnoses after documented trauma, tracking cardiovascular outcomes separately by sex. Machine learning ranked 15 mental health conditions; alcohol abuse ranked first for both men and women, followed by mood disorders that showed stronger weighting in women. Absolute risks rose from baseline 2-4% to 7-11% over the observation window, with relative hazards 1.6-2.3 after adjustment for age and prior cardiovascular disease. The study extends prior PTSD-focused work by demonstrating that substance-use and personality disorders carry comparable or greater cardiovascular signal. Unmeasured behavioral pathways, including sustained smoking, poor medication adherence, and sympathetic overdrive, likely mediate much of the observed association rather than direct inflammatory effects alone. Earlier U.S. cohort studies in JAMA Psychiatry (2017) and Circulation (2021) reported similar gradients but lacked the registry power to rank predictors by sex. Next steps require prospective cohorts that measure inflammatory biomarkers and objective alcohol biomarkers at multiple post-trauma intervals, followed by randomized trials of integrated addiction-cardiology care. Without such data, causal claims remain limited to observational associations. Evidence quality is moderate: large registry design reduces selection bias yet cannot establish temporality of unmeasured confounders or rule out surveillance bias in psychiatric care.