The Vietnam War has been over for more than four decades, but many veterans and their families are still battling life-threatening health problems. New research has added more conditions to the long list of problems faced by those who were exposed to the notorious exfoliant Agent Orange.

A study by the National Academies of Sciences, Engineering and Medicine shows a link between exposure to the chemicals and increased high blood pressure and a condition that can lead to the cancer multiple myeloma. These join other afflictions the Department of Veterans Affairs says are presumed to be related to herbicide exposure in Vietnam, including Hodgkin’s disease, prostate cancer, heart disease, leukemia and Parkinson’s disease.

The U.S. military sprayed herbicides over the jungles of Vietnam from 1962 to 1971 to clear the thick canopy and tall grasses that shielded the enemy. The most commonly used mixture was Agent Orange, which contained the toxic chemical dioxin. No one knows how many U.S. military personnel may have been exposed to Agent Orange, but more than 4 million Americans served in the war.

Those vets are now in their later years, making it hard to say with certainty the diseases they are suffering come from Agent Orange. However, the study included a VA report that showed hypertension rates were highest among vets who had the greatest exposure to Agent Orange.

The study also found there has been scant research into the health effects on children of these vets. Some reports have shown high rates of spina bifida among children of Vietnam vets, but that link has not been fully examined.

The veterans came home from Vietnam, but it seems the war came with them.