Increased risk for cardiac ischemia in patients with PTSD

December 2, 2013

There is growing concern that long-term untreated posttraumatic stress disorder (PTSD) symptoms may increase the risk of developing a number of medical problems, particularly compromised cardiovascular health.

Heart disease remains the leading cause of death worldwide, according to the World Health Organization. Cardiovascular disease is an umbrella term for diseases of the heart and blood vessels. There are multiple known risk factors, including age, family history, smoking, obesity, , and .

Prior studies show that individuals with PTSD are at increased risk of . However, most of these studies proposed this relationship on the basis of self-report measures, creating a need for objective studies to establish the validity of this hypothesis.

In this issue of Biological Psychiatry, Jesse Turner and colleagues at the University of California, San Francisco have done just that and now report new evidence of elevated rates of myocardial ischemia in patients with PTSD.

They recruited 663 outpatients from two Veterans Affairs Medical Centers who underwent a series of assessments, including questionnaires and a blood test to determine their risk factors for cardiovascular disease. Each also completed a structured interview with a clinician, which resulted in a diagnosis of PTSD for 230 of the veterans. Lastly, the participants performed standardized exercise treadmill tests, commonly called 'stress tests', which were used to detect ischemia.

The researchers detected the presence of in 17% of the participants with PTSD but only 10% of participants without PTSD. This increase was not explained by differences in traditional cardiac risk factors, health behaviors like alcohol use and sleep quality, or depression.

"Persistent PTSD symptoms produce more than psychological distress; they constitute a major adaptive challenge for the entire body," commented Dr. John Krystal, Editor of Biological Psychiatry. "Increased risk for cardiac ischemia may turn out to be an important new concern for individuals suffering from long-standing untreated PTSD."

"This study adds to a growing literature demonstrating the objective effects of PTSD on the heart. An important next step for this area of research will be to identify the mechanisms through which PTSD may damage the cardiovascular system. Though we controlled for several potential mechanisms, such as traditional cardiovascular disease risk factors, these did not explain the association of PTSD and ischemia," said Dr. Beth Cohen, senior author on the project. "Determining precisely how PTSD can affect the heart will allow us to develop new, tailored treatments to improve the health of veterans and others who experience PTSD."

Considering that up to 30% of veterans suffer from PTSD, this is an important goal. For now, it is increasingly clear that, veteran or not, any individuals suffering from PTSD should seek treatment.

Explore further: PTSD raises risk for obesity in women

More information: The article is "Objective Evidence of Myocardial Ischemia in Patients with Posttraumatic Stress Disorder" by Jesse H. Turner, Thomas C. Neylan, Nelson B. Schiller, Yongmei Li, and Beth E. Cohen (DOI: 10.1016/j.biopsych.2013.07.012). The article appears in Biological Psychiatry, Volume 74, Issue 11 (December 1, 2013)

Related Stories

PTSD raises risk for obesity in women

November 20, 2013

Women with post-traumatic stress disorder (PTSD) gain weight more rapidly and are more likely to be overweight or obese than women without the disorder, find researchers at Columbia University's Mailman School of Public Health ...

PTSD linked to increase risk in heart disease

June 1, 2011

(Medical Xpress) -- New research by Dr. Ramin Ebrahimi and his team from the Greater Los Angeles Veterans Administration Medical Center was published in The American Journal of Cardiology and shows a link between post-traumatic ...

Poor sleep linked to PTSD after heart attack

May 30, 2013

Clinicians have long speculated that poor sleep may be a mechanism involved in the higher risk of further cardiac events or death among those with post-traumatic stress disorder following a heart attack, but the association ...

Young vets with PTSD receive more CT scans

May 2, 2013

(HealthDay)—Computed tomography (CT) scans are significantly more commonly used in young veterans with posttraumatic stress disorder (PTSD) compared to young veterans without PTSD, according to research published in the ...

Recommended for you

Elderly may face increased dementia risk after a disaster

October 24, 2016

Elderly people who were uprooted from damaged or destroyed homes and who lost touch with their neighbors after the 2011 tsunami in Japan were more likely to experience increased symptoms of dementia than those who were able ...

Research examines role of early-life stress in adult illness

October 24, 2016

Scientists have long known that chronic exposure to psychosocial stress early in life can lead to an increased vulnerability later in life to diseases linked to immune dysfunction and chronic inflammation, including arthritis, ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.