Posttraumatic Stress Disorder and Nocturnal Blood Pressure Dipping in Young Adult African Americans

Mellman, Thomas A.; Brown, Denver D.; Jenifer, Ericka S.; Hipolito, Maria; Randall, Otelio S.

doi:10.1097/psy.0b013e3181a54341

Cited by 37 publications

(35 citation statements)

References 27 publications

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“…For example, studies investigating indirect markers of sympathetic activity show that PTSD patients have higher resting heart rates and blood pressure, decreased heart rate variability, and increased plasma and urine catecholamine levels, suggesting a state of SNS overactivity (9,16). In addition, failure of blood pressure (BP) to decrease by Ն10% nocturnally (nondipping), which is thought to be mediated by SNS overactivity, is associated with increased CVD risk and is more prevalent in young AfricanAmericans with PTSD (72).…”

Section: Autonomic Dysfunction In Ptsdmentioning

confidence: 99%

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Brudey

Park

Wiaderkiewicz

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

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105

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-Stressand anxiety-related disorders are on the rise in both military and general populations. Over the next decade, it is predicted that treatment of these conditions, in particular, posttraumatic stress disorder (PTSD), along with its associated longterm comorbidities, will challenge the health care system. Multiple organ systems are adversely affected by PTSD, and PTSD is linked to cancer, arthritis, digestive disease, and cardiovascular disease. Evidence for a strong link between PTSD and cardiovascular disease is compelling, and this review describes current clinical data linking PTSD to cardiovascular disease, via inflammation, autonomic dysfunction, and the renin-angiotensin system. Recent clinical and preclinical evidence regarding the role of the renin-angiotensin system in the extinction of fear memory and relevance in PTSD-related immune and autonomic dysfunction is also addressed. posttraumatic stress disorder; cardiovascular disease; renin-angiotensin system POSTTRAUMATIC STRESS DISORDER (PTSD) is a psychiatric illness characterized by persistent emotional and mental stress following a traumatic event. Symptoms of PTSD include hyperarousal, flashbacks, intrusive thoughts, or nightmares, and avoidance of activities that trigger memories of the traumatic event. The health consequences of PTSD are substantial, affecting multiple organ systems, with evidence linking PTSD to diseases such as cancer, arthritis, digestive disease, and cardiovascular disease (CVD) (13,14,112). The evidence demonstrating increased risk for CVD in PTSD (9,15,19,49,57,58) is compelling, and several excellent recent review articles have highlighted this association (20,23,52,63,112). While this association could certainly be due, in part, to related unhealthy behaviors, such as increased prevalence of smoking, poor diet, and physical inactivity (46,119). Yet even after adjustments for lifestyle, comorbid conditions, and combat engagements in multivariate models, PTSD remains a significant and independent risk factor for the development of CVD and CVD-related mortality (15).Increased CVD risk in PTSD has been demonstrated in both military (21) and civilian populations (44,82). A co-twin study design (monozygotic and dizygotic), which controlled for genetic and familial confounders, demonstrated that the incidence of coronary heart disease was more than double in Vietnam War veteran twins with PTSD (22.6%) compared with those without PTSD (8.9%) (106). Most recently, one of the largest longitudinal studies examining the association between PTSD and heart failure was completed, and veterans with PTSD were shown to be nearly 50% more likely to develop heart failure than veterans without PTSD (91). This remained significant after adjustments for age, sex, diabetes, hyperlipidemia, hypertension, body mass index, combat, and military service. Civilian PTSD populations are also at greater risk for CVD. Following life-threatening traumatic events such as earthquakes (82), the 9 -11 World Trade Center attack (45), and living in urban dis...

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Section: Autonomic Dysfunction In Ptsdmentioning

confidence: 99%

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Brudey

Park

Wiaderkiewicz

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

Self Cite

105

View full text Add to dashboard Cite

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“…8 On the whole, the available literature on nondipping and psychosocial variables is scarce, with results often based on small clinical samples, resulting in mixed findings. [10][11][12][13][14][15] Moreover, to our knowledge no studies have examined work-related stress in relation to nondipping in a sample of people at work.…”

Section: Introductionmentioning

confidence: 99%

“…12 On the other hand, no studies have reported on the relation between work-related stress and nondipping in a working sample. Our results clearly suggest that job strain is an independent risk factor for nondipping.…”

mentioning

confidence: 99%

Behavioural and psychosocial correlates of nondipping blood pressure pattern among middle-aged men and women at work

et al. 2011

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The underlying pathogenetic mechanisms of nondipping blood pressure (BP) pattern are not completely understood. Especially the role of psychosocial correlates remains unclear. The aim was to assess the association between nondipping BP pattern, behavioural and psychosocial factors in a sample of working men and women. The study sample included 167 working men and women aged 40-64 years from the BELSTRESS cohort. Sociodemographic, behavioural and psychosocial factors were assessed by self-administered questionnaires. Participants were medically examined and underwent an ambulatory BP monitoring during 24 h. Nondipping was defined when the average nocturnal decline in BP was o10%. The prevalence of nondipping for both systolic and diastolic BP was 7.8%. Nondipping was not significantly related to smoking, alcohol consumption and leisure time physical activity. A crude significant association was observed between nondipping and sleep problems. After adjusting for gender, education and body mass index, the risk for nondipping was associated with job strain, living alone, being unsatisfied about the contact with one's children, depressive symptoms and vital exhaustion. Nondipping BP pattern was consistently related to psychosocial factors in this study: positive associations were observed with measures of job strain, poor private life support (living alone and being unsatisfied about the contact with one's children) and mental health problems (depressive symptoms and vital exhaustion).

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“…11- 16 Only a few reports have evaluated nocturnal and early morning BP in association with mental disorders. 17 Most of the BP data reported in large-scale studies on anxiety disorder and hypertension overseas are based on measurements taken during physician check-up or at home. 11-14 Thus, few studies have investigated how psychological stress influences nocturnal BP, early morning BP and morning BP surge in patients with hypertension.…”

mentioning

confidence: 99%

Anxiety Disorder Is Associated With Nocturnal and Early Morning Hypertension With or Without Morning Surge

Kayano

Koba

Matsui

et al. 2012

Circ J

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Background: Nocturnal and early morning hypertension are both significant risk factors for cardiovascular events. It remains unclear whether anxiety disorder affects nocturnal blood pressure (BP), early morning BP, or BP pattern in hypertensive patients. Methods and Results:One hundred and twenty consecutive hypertensive outpatients (77 men and 43 women; mean age, 66±11 years) were divided into 2 groups based on Hospital Anxiety and Depression Scale (HADS) score: a control group (n=78; HADS ≤10) and an anxiety group (42 patients; HADS ≥11). Nocturnal BP, early morning BP, morning BP surge (defined as BP rise ≥50 mmHg), and BP pattern (extreme-dipper/dipper/non-dipper/riser) were measured on ambulatory BP monitoring. Clinical characteristics and BP were also evaluated at physician check-up. There was no significant difference between the 2 groups for BP check-up, but nocturnal and early morning BP were significantly higher in the anxiety group (142±16 mmHg and 152±21 mmHg) than in the control group (126±14 mmHg and 141±18 mmHg). With regard to patients with morning BP surge, nocturnal and early morning BP were also significantly higher in the anxiety group. The relative risk of existing anxiety disorders in riser-type hypertension was 4.48-fold higher (95% confidence interval: 1.58-12.74; P<0.005) than in dipper-type hypertension. Conclusions:Anxiety disorder is associated with nocturnal and early morning hypertension, and may be a risk factor for cardiovascular events. (Circ J 2012; 76: 1670 - 1677

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Posttraumatic Stress Disorder and Nocturnal Blood Pressure Dipping in Young Adult African Americans

Abstract: Elevated nocturnal BP may be a link between PTSD and cardiovascular morbidity in AAs that can be targeted in prevention.

Cited by 37 publications

References 27 publications

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Behavioural and psychosocial correlates of nondipping blood pressure pattern among middle-aged men and women at work

Anxiety Disorder Is Associated With Nocturnal and Early Morning Hypertension With or Without Morning Surge

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