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Veterans with PTSD may have worse endothelial function, increasing risk for MI, stroke
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PTSD may affect endothelial function, increasing the risk for MI and stroke in veterans, researchers reported in the Journal of the American Heart Association.
“Traditional risk factors such as high [BP], diabetes, high cholesterol and smoking have not fully explained why people with PTSD seem to be at higher heart disease risk. Our study suggests that chronic stress may directly impact the health of the blood vessels,” Marlene Grenon, MD, MMSc, FRCSC, associate professor of surgery at the University of California, San Francisco, and vascular surgeon at the Veterans Affairs Medical Center San Francisco/Veterans Affairs Medical Center-Surgical Services, said in a press release.
Marlene Grenon
The researchers enrolled 67 veterans with PSTD and 147 veterans without PSTD from the Veterans Affairs Medical Center in San Francisco and compared their brachial artery flow-mediated dilation scores, which test endothelial function. PTSD was measured as a score of 40 or higher on the PTSD Symptom Checklist.
The average age of the veterans with PTSD was 68 years, and 99% of them were men. The average age of the veterans without PTSD was 69 years, and 91% of them were men. Veterans with PTSD were more likely be diagnosed with depression (58% vs. 8%; P < .0001) and less likely to be on BP medication (ACE inhibitors, 17% vs. 36%; P = .007; beta-blockers, 25% vs. 41%; P = .03). According to quartiles of the PTSD Symptom Checklist scores, most of the veterans with PTSD were at lower risk levels.
Grenon and colleagues found that the blood vessels of veterans with PTSD could only dilate 5.8% in reaction to stimuli while the blood vessels of veterans without PTSD could expand 7.5% (P = .003). Lower flow-mediated scores also were associated with increasing age (P = .008), decreasing estimated glomerular filtration rate (P = .003), hypertension (P = .002), aspirin use (P = .03) and beta-blocker treatments (P = .01). Even after adjustments, an independent association remained between PTSD and lower flow-mediated vasodilation (P = .0005).
According to the researchers, there was a 2.4% adjusted difference in flow-mediated dilation scores between the two groups, which is significant because a recent meta-analysis found that just a 1% decrease is associated with a 10% increase in future CV events and mortality.
“We need to determine better ways we can help people manage PTSD and other types of stress to reduce the negative impact of chronic stress on blood vessels. At the Veterans Administration in San Francisco, we are in the process of starting a multidisciplinary vascular rehabilitation clinic to try to better manage traditional and non-traditional risk factors, including stress, to improve [CV] health,” Grenon said in the release. – by Tracey Romero
Disclosure: The researchers report no relevant financial disclosures.
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