February 13, 2019
2 min read

PTSD with other factors increase risk for CVD

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The increased risk for CVD in patients with PTSD was associated with psychiatric and physical conditions, in addition to smoking, according to a study published in the Journal of the American Heart Association.

“This suggests there is no single comorbidity or behavior that explains the link between PTSD and cardiovascular disease,” Jeffrey Scherrer, PhD, professor and director of the division of research in the department of family and community medicine at the Saint Louis University School of Medicine, said in a press release. “Instead, a combination of physical disorders, psychiatric disorders and smoking — that are more common in patients with PTSD vs. without PTSD — appear to explain the association between PTSD and developing cardiovascular disease.”

Researchers analyzed Veterans Affairs electronic medical record data from 4,178 patients (mean age, 50 years; 87% men) who had two or more visits to a VA medical center between 2008 and 2012. Patients were either in the PTSD group (n = 2,519; mean age, 49 years; 87% men) or the control group (n = 1,659; mean age, 52 years; 87% men).

Data that were assessed included vital signs, diagnosis codes, medications, laboratory results, type of clinic encounter and demographic data. Patients did not have CVD for at least 1 year before the index date, which was defined as either the second visit to a clinic for the control group or the second visit with a PTSD diagnosis for those in the PTSD group.

PTSD was significantly linked to incident CVD after adjusting for age (HR = 1.41; 95% CI, 1.21-1.63). This relationship weakened but remained significant after adjusting for physical conditions (HR = 1.23; 95% CI, 1.06-1.44).

The association between PTSD and CVD was no longer present after adjusting for sleep disorders, substance abuse/dependence, smoking and other anxiety disorder and depression diagnoses (HR = 0.96; 95% CI, 0.81-1.15).

“Recognizing that PTSD does not preordain CVD may empower patients to seek care to prevent and/or manage CVD risk factors,” Scherrer and colleagues wrote. “Patients without PTSD are also at risk of CVD if they smoke, have sleep disorder, depression or metabolic disease. In both patient populations, the risk of CVD can be mitigated with health behavior change and effective chronic disease management.” – by Darlene Dobkowski

Disclosures: The study was supported by the NHLBI. Scherrer reports he receives compensation as an editor for Family Practice. Please see the study for all other authors’ relevant financial disclosures.