Posttraumatic Stress and Cardiovascular Disease Risk

Abstract

A growing literature indicates that posttraumatic stress is associated with cardiovascular risk and cardiovascular disease (CVD). Research on specific CVD risk factors and their prevalence in posttraumatic stress disorder (PTSD) may improve understanding of CVD development in this population. The primary purpose of the present article is to outline the evidence relating posttraumatic stress to CVD risk, with an emphasis on behavioral factors. The evidence concerning potential elevations in traditional cardiovascular risk factors with behavioral components in PTSD is reviewed. Brief discussions of autonomic nervous system hyperarousal and immune dysfunction as potential mechanisms for CVD risk are also presented. Together, the available evidence suggests that multiple related risk factors and physiological systems may impact health in PTSD. Based on the literature to date, it is suggested that additional studies are needed on the synergistic effects of multiple interacting CVD risk factors and interventions aimed at primary and secondary prevention of cardiovascular risk.

Posttraumatic stress disorder and hypertension in Australian veterans of the 1991 Gulf War

“…There are consistent reports that smokers with PTSD tend to smoke greater quantities than smokers without PTSD [5]. However, we found no significant difference in the pack year history of smoking between those with and without PTSD, perhaps because non-smokers were included in this analysis.…”

“…For instance, PTSD has numerous neuroendocrine manifestations [1][2][3][4], including sympathetic nervous system overactivity. It has been hypothesised that this may be associated with long-term alterations in baroreceptors that regulate blood pressure [1,5], and that PTSD may pose a risk of hypertension by this mechanism. Furthermore, behavioural factors may mediate associations between PTSD and hypertension [5] -elevated alcohol intake is common in military populations [6] and amongst people with PTSD [1] and is also a known risk factor for hypertension in males [7,8].…”

Immunomodulatory Effects of in vitroStress Hormones on FoxP3, Th1/Th2 Cytokine and Costimulatory Molecule mRNA Expression in Human Peripheral Blood Mononuclear Cells

“…Altered numbers and function of these immunoregulatory components have been implicated in autoimmune, allergic and even certain malignant diseases [23] . Interestingly, psychological stress has a proposed adverse role in the clinical activity and perhaps etiologies of these diseases as well [24][25][26] . This supports the potential clinical value of further defining possible relationships between psychological The PBMC culture system utilized in this study has been previously used as a model to study the effects of stress hormones on Th1/Th2 cytokine balance [9] .…”

Posttraumatic Stress Disorder and Cardiometabolic Disease

“…Trauma-/stress-related anxiety disorders, particularly PTSD, confer SNS hyperarousal, HPA axis dysregulation, proinflammatory activation, obesity, and sleep disturbances, conditions conducive not only to the development of the metabolic syndrome but also of CHD [144,150]. …”