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Blood pressure may predict prazosin treatment response in PTSD

Higher blood pressure at baseline may indicate future positive treatment response to prazosin among individuals with PTSD.

“These findings suggest that higher standing blood pressure is a biomarker that can contribute to a personalized medicine approach to identifying soldiers and veterans with combat PTSD likely to benefit from prazosin,” study researcher Murray Raskind, MD, of the VA Puget Sound Health Care System and the University of Washington in Seattle, said in a press release.

To assess associations between baseline standing systolic blood pressure and other blood pressure parameters on PTSD outcomes, researchers analyzed data from a previously reported randomized controlled trial for 32 individuals treated with prazosin and 35 treated with placebo.

For each 10-mm Hg higher baseline standing systolic blood pressure increment,

Clinician-Administered PTSD Scale (CAPS) total scores decreased by an additional 14 points at end point among participants who received prazosin (P = .002).

There was a similar significant effect for baseline supine systolic blood pressure, with an additional 9-point decrease in CAPS score for every 10-mm Hg increase in baseline supine systolic blood pressure (P = .04).

All other combinations of baseline blood pressure parameters and PTSD outcomes were similarly significant or exhibited trends in the predicted direction, according to researchers.

Analysis indicated no significant associations between baseline blood pressure and PTSD outcomes among participants who received placebo.

“The increase in blood pressure in these PTSD patients may be a biomarker for patients who are more likely to benefit from prazosin,” John Krystal, MD, editor of Biological Psychiatry, said in the release. “If so, it may be a useful indicator of activation of noradrenergic activation associated with PTSD in these patients.” – by Amanda Oldt

Disclosure: Raskin reports a serving as a paid advisory board member for Pfizer, Merck, and Takeda Pharmaceuticals. Please see the study for a full list of relevant financial disclosures.