Patients with PTSD at risk for developing CVD, diabetes

SAN FRANCISCO — Patients diagnosed with post-traumatic stress disorder are more likely to develop insulin resistance and metabolic syndrome compared with those that are not diagnosed with the disorder, increasing their risk for developing cardiovascular disease or diabetes.

Perspective from Alfred Bove, MD, PhD

“This is a disorder that needs to be looked at and treated as a public health problem,” Ramin Ebrahimi, MD, professor of medicine at the University of California in Los Angeles, said during a press conference at the American College of Cardiology Scientific Sessions. “This calls for a well designed prospective trial to evaluate the potential role of PTSD in development of cardiovascular and metabolic disorders.”

Ebrahimi and colleagues utilized VA electronic medical data to identify the incidence of insulin resistance (defined as triglyceride over HDL cholesterol ratio ≥3.8) and metabolic syndrome in 207,954 patients (mean age 60 years; 14.93% men). According to data, patients without known coronary artery disease and diabetes, with and without post-traumatic stress disorder (PTSD) were followed for the median study duration time of 2 years.

At baseline, there were no differences in age, gender, lipid profile, fasting blood glucose and conventional risk factors among patients with and without PTSD (P>.05). However, insulin resistance was significantly greater among patients with PTSD compared with those without PTSD at follow-up (34.8% vs. 19.3%; P=.00001), according to data. Moreover, metabolic syndrome was significantly greater in patients with PTSD compared with patients without PTSD (52.5% vs. 37.3%; P=.0001). Ebrahimi and colleagues also reported an excess incidence rate of 14.20% for insulin resistance (95% CI, 17.83-18.53) and 12.07% for metabolic syndrome (95% CI, 13.73-14.42) in those with PTSD vs. those without. Based on these findings, researchers suggest early detection and management of PTSD-related medical conditions including metabolic syndrome and atherosclerosis. – by Samantha Costa

For more information:

Ebrahimi R. Abstract #1102-19. Presented at: American College of Cardiology Scientific Sessions; March 9-11, 2013; San Francisco.

Disclosure: Ebrahimi reports financial ties with Boehringer-Ingelheim, Abbott Vascular, The Medicines Company, Sanofi-Aventis and Gilead.

Perspective

Alfred Bove, MD, PhD

We know that populations under stress seem to gain weight. For instance, I work in Philadelphia and our inner city population has a BMI of 33 and an average HbA1c of 6.6% in the population. One of the questions in this presentation was whether PTSD invokes more caloric intake and leads to patient’s becoming overweight and the consequences of that response. I also found the secondary results interesting regarding lipids and blood sugar. However, the findings are not absolutely clear. The VA has an expansive database and I believe they are going to conduct additional research into that database to answer further questions.

Alfred Bove, MD, PhD

Professor of medicine in the department of cardiology

Cardiovascular Research Center

Temple University School of Medicine

Disclosures: Bove reports consultancy/honoraria fees and partnership principal from Health System Networks, Inc., Insight Telehealth Inc.