Post-traumatic stress disorder as a predictor for incident hypertension: a 3-year retrospective cohort study

Abstract

Background The goal of the present study was to investigate the association between PTSD and the onset of hypertension in previously normotensive individuals in a population living in the stressful environment of the urban slums while controlling for risk factors for cardiovascular disease (CVD). Methods Participants were 320 normotensive individuals who lived in slums and were attending a family doctor program. Measurements included a questionnaire covering sociodemographic characteristics, clinical status and life habits, the Posttraumatic Stress Disorder Checklist – Civilian Version, and the Beck Depression Inventory. Incident hypertension was defined as the first occurrence at the follow-up review of the medical records of (1) systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher, (2) the participant started taking antihypertensive medication, or (3) a new diagnosis of hypertension made by a physician. Differences in sociodemographic, clinical, and lifestyle characteristics between hypertensive and non-hypertensive individuals were compared using the χ2 and t tests. Multivariate Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results Six variables – age, educational level, body mass, smoking, diabetes, and PTSD diagnosis – showed a statistically significant (p ≤ 0.20) association with the hypertensive status. In the Cox regression, only PTSD diagnosis was significantly associated with incident hypertension (multivariate HR = 1.94; 95% CI 1.11–3.40). Conclusions The present findings highlight the importance of considering a diagnostic hypothesis of PTSD in the prevention and treatment of cardiovascular diseases.

2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension

“…Patients with mental distress may develop a sudden increase in BP, which may normalize when the distress is relieved [456]. Growing evidence also links the exposure to intensely traumatic life events with an increased risk of hypertension [456][457][458][459]. Recent meta-analyses report promising results for the ability of mind-body stress reducing interventions to not only reduce stress and mood swings but also SBP and DBP, although the quality of the evidence is low [366,460].…”

Evaluation of Patients Diagnosed with Essential Hypertension in Terms of Mental and Personality Disorders

“… 15 Additionally, post-traumatic stress disorder diagnosis was found significantly associated with incident hypertension in the literature. 16 , 17 It has also been noted that psychological factors are effective in regular treatment and medication compliance of hypertension patients. 18 Furthermore, comorbid hypertension and anxiety were associated with lower treatment adherence, lower quality of life, lower levels of daily functioning, and higher health-care costs.…”