PTSD Linked to Increased Myocardial Ischemia

SAN FRANCISCO — A new study adds to the growing evidence that patients with post-traumatic stress disorder (PTSD) also have increased risks for developing myocardial ischemia.

The study, published recently in Biological Psychiatry, was conducted by University of California, San Francisco researchers at two VAMCs. 1

For the research, 663 VA outpatients underwent a series of assessments, including questionnaires and a blood test to determine their risk factors for cardiovascular disease. Each veteran also participated in a structured interview with a clinician, resulting in a diagnosis of PTSD for 230 of the subjects. Participants also underwent standardized exercise treadmill tests to detect ischemia.

Myocardial ischemia was identified in 17% of the participants with PTSD but only 10% of participants without PTSD. Researchers emphasized that the increase was not explained by differences in traditional cardiac risk factors, health behaviors like alcohol use and sleep quality or depression.

“This study adds to a growing literature demonstrating the objective effects of PTSD on the heart,” said co-author Beth Cohen, MD. “An important next step for this area of research will be to identify the mechanisms through which PTSD may damage the cardiovascular system. Though we controlled for several potential mechanisms, such as traditional cardiovascular disease risk factors, these did not explain the association of PTSD and ischemia. Determining precisely how PTSD can affect the heart will allow us to develop new, tailored treatments to improve the health of veterans and others who experience PTSD.”

John Krystal, MD, editor of Biological Psychiatry, commented that “increased risk for cardiac ischemia may turn out to be an important new concern for individuals suffering from long-standing untreated PTSD.”

  1. Turner, JH, Neylan TC, Schiller NB, Li Y, Cohen BE. Objective Evidence of Myocardial Ischemia in Patients with Posttraumatic Stress Disorder. Biological Psychiatry, 2013; 74 (11): 861 DOI: 10.1016/j.biopsych.2013.07.012

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