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PTSD Creates Unique Risk for Cardiovascular Disease

Cardiovascular disease, or CVD, is the collective medical term for diseases that significantly degrade the health of the heart or the vessels that carry blood back and forth from the heart to the body. Roughly one-third of U.S. adults have a heart or blood vessel ailment, and cardiovascular problems often prove deadly. People affected by the mental health condition post-traumatic stress disorder (PTSD) develop CVD with unusual frequency. According to the results of a study published in August 2013 in the journal Biological Psychiatry, the risks for cardiovascular disease in PTSD-affected individuals are uniquely separate from other established CVD risks.

Cardiovascular Disease Basics

Although cardiovascular diseases can affect either the heart or the blood vessels, doctors and the general public often refer to these conditions simply as heart disease. The most prominent forms of CVD are heart attacks, which occur when heart muscle tissue loses its required blood supply; ischemic strokes, which occur when blockage in a blood vessel stops blood from flowing to the brain; and hemorrhagic strokes, which occur when a blood vessel supplying the brain breaks open. Additional common forms of cardiovascular disease include an irregular heartbeat rhythm (known as arrhythmia), insufficient pumping action inside the heart (known as heart failure) and various problems or abnormalities in the heart valves that form the gateways between the heart’s four chambers, as well as between the heart and the body.

One of the most prominent risk factors for CVD is a preventable, abnormal hardening of the arteries called atherosclerosis, the American Heart Association reports. Some of the other identified cardiovascular disease risks are also preventable (or at least controllable), including such things as smoking, high LDL cholesterol levels, a physically inactive lifestyle, consumption of a high-fat diet, diabetes, unmanaged stress, hypertension, obesity and alcohol or drug abuse/addiction. Known unavoidable risks for CVD include a family history of cardiovascular disease, advancing age, Asian or African ethnic heritage and prior experience of a heart attack.

PTSD Basics

Post-traumatic stress disorder occurs when a life-threatening or seemingly life-threatening event overwhelms the body’s natural mechanisms for adapting to high-stress situations. It produces classic symptoms such as strongly negative states of mind, nightmares or flashbacks, avoidance of any trauma reminders and an ongoing state of jitteriness or unusually high emotional/mental vigilance. Most people adapt to potentially traumatic situations in a relatively short period of time and don’t develop PTSD. However, substantial numbers of people do develop PTSD, especially under the influence of certain trauma-related factors. According to the National Center for PTSD, factors likely to contribute to the disorder’s onset include experiencing an injury during a traumatic event, witnessing other people’s injuries during an event, experiencing an extreme emotional reaction immediately after an event, experiencing a severe or long-lasting form of trauma, feeling out of control during an event and lacking sufficient emotional support in the days and weeks following an event.

New Findings

In the study published in Biological Psychiatry, researchers from the University of California, San Francisco and the Department of Veterans Affairs assessed the rate of cardiovascular disease in 663 participating veterans, and also sought to determine which contributing factors increase a PTSD-affected individual’s cardiovascular disease risks. Some of the veterans enrolled in the study had a diagnosis for PTSD, while others did not. The presence of CVD was detected with the help of a procedure called a treadmill test, which uses controlled physical exertion to uncover and track abnormalities in heart and blood vessel health.

In their preliminary findings, the researchers concluded that, while only 10 percent of the participating veterans unaffected by PTSD had signs of cardiovascular disease, 17 percent of the participants with a PTSD diagnosis had signs of CVD. This difference was determined to be both statistically and medically significant. In order to find out which specific risk factors are responsible for elevating the cardiovascular risks of people with PTSD, the researchers made a series of calculations designed to isolate each potential factor one at a time. However, even when all traditional risk factors for cardiovascular disease (and certain additional factors, such as depression, inadequate sleep and inflammation inside the body) were accounted for, the veterans affected by post-traumatic stress disorder still developed CVD more often than their unaffected peers.

Significance

Based on their findings, the authors of the study published in Biological Psychiatry believe that people affected by PTSD have unique risk factors for cardiovascular disease that differ substantially from the risk factors usually associated with poor heart and/or blood vessel health. However, they also believe that doctors can use the presence of PTSD itself as an indication that any given patient is at substantial risk for CVD, and then use that knowledge to begin preventive interventions at the earliest possible date. In addition, the authors point toward an obvious need to increase understanding of the reasons PTSD so sharply reduces cardiovascular health.

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