By Annette M. Boyle
SAN FRANCISCO — The relationship between post-traumatic stress disorder (PTSD) and elevated risk for cardiovascular disease and mortality has been well documented in recent years. How PTSD specifically affects heart health, however, has been less clear.
A study at the San Francisco VA sought to add to that information and found that one mechanism might be an impairment in the ability of blood vessel to dilate in response to stimulus or endothelia dysfunction.
Using flow-mediated brachial artery vasodilation (FMD), researchers measured how well an artery responds to changes in pressure as a blood pressure cuff expands and contracts. They found that, in veterans with PTSD, the arteries were unable to expand normally, which increases the risk of heart attack and stroke.
In an article about the study in the Journal of the American Heart Association, the researchers noted that “it has been estimated that a 1% decrease in FMD is predictive of a 10% absolute increase in future cardiovascular events and mortality.”
The San Francisco VA study found that veterans with PTSD have a 2.4% reduction in FMD, which would increase their risk of cardiovascular events and mortality by nearly 25%, according to co-author Mary Whooley, MD, an investigator at NCIRE, the Veterans Health Research Institute, as well as a physician at the San Francisco VAMC and professor of medicine, epidemiology and biostatistics at the University of California, San Francisco.1
The study measured FMD in 67 veterans with PTSD and 147 veterans without the disorder. Veterans with PTSD had a dilation of 5.8% compared to 7.5% in veterans without PTSD, a sign of impaired endothelia function. Researchers also found a strong correlation between declining FMD response and deteriorating renal function, hypertension and age, but multivariate analysis confirmed the association of PTSD and impaired vasodilation.