PTSD Alone Not Linked to CVD

Having post-traumatic stress disorder (PTSD), in and of itself, may not increase the risk for cardiovascular disease (CVD), according to a study published online in the Journal of the American Heart Association.

Rather, factors that often co-exist with PTSD may explain why people with this condition have increased risk for CVD.

“Our findings suggest that exposure to smoking, and physical and psychiatric disorders explain the increased risk of CVD in patients with PTSD. Because these conditions are more common in patients with PTSD, closer monitoring for comorbidities may be warranted,” wrote researchers led by first author Jeffrey Scherrer, PhD, of Saint Louis School of Medicine, Missouri.

“Recognizing that PTSD does not preordain CVD may empower patients to seek care to prevent and/or manage CVD risk factors,” they added.

Several past studies have found a link between PTSD and increased risk for CVD, but people with PTSD have a broad range of other psychiatric and medical problems that may also contribute to this risk. These commonly include smoking, high blood pressure, diabetes, alcohol and other substance abuse, and depression/anxiety.

In the study, researchers analyzed medical records at Veterans Health Affair centers across the US. The study included patients without CVD at baseline, of which 2519 had PTSD and 1659 did not. Included patients were 87% male and 60% white, with an average age of 50 years.

Results adjusted for age suggested that PTSD was linked to significantly increased risk for CVD, approximately 41% higher risk compared to not having PTSD. The association decreased by about 44% in analyses adjusted for medical conditions like diabetes and hypertension, but results remained significant.

However, in analyses adjusted for smoking, sleep disorders, substance use, anxiety, and depression, the association between PTSD and CVD was no longer significant.

That suggests no single medical problem or health-related behavior accounted for the link between PTSD and CVD, and that a combination of factors may be involved.

Follow-up ranged from 3 to 8 years, which may not have been long enough to capture lifetime CVD risk. Most patients were under 60, so results may only represent early onset CVD.

REFERENCE

Scherrer JF, Salas J, Cohen BE, et al. Comorbid conditions explain the association between posttraumatic stress disorder and incident cardiovascular disease. J Am Heart Assoc. 2019;8:e011133.