Letter to the EditorPTSD is a risk factor for cardiovascular disease: Time for increased screening and clinical intervention☆
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Conflict of interest statement
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Cited by (24)
PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans
2019, Preventive Medicine ReportsCitation Excerpt :Prior research suggests these associations are due to CVD and diabetes risk factors common among individuals with PTSD, such as over-activation of the hypothalamic-pituitary-adrenal (HPA) stress axis, inflammation, conditions such as obesity and hypertension, and poor health behaviors like tobacco use (Boscarino, 2012; Dedert et al., 2010). Regarding the latter, evidence suggests tobacco use is elevated among individuals with PTSD both due to nicotine use for emotional regulation and genetic risk factors (Boscarino, 2012). Dedert et al. (2010) proposed a theoretical model to comprehensively explain and help guide study of the association of PTSD with these outcomes and to inform clinical practice (see Fig. 1).
Biological predictors of insulin resistance associated with posttraumatic stress disorder in young military veterans
2017, PsychoneuroendocrinologyCitation Excerpt :In addition to distressing psychological symptoms, individuals with PTSD are at increased risk for medical health problems. In particular, PTSD substantially increases risk for cardiovascular disease (CVD) (Boscarino, 2012; Edmondson et al., 2013; Kubzansky et al., 2007; Vaccarino et al., 2013) and Type 2 diabetes (T2D) (Roberts et al., 2015; Vancampfort et al., 2016), (collectively referred to as cardiometabolic disease), even after controlling for comorbid major depressive disorder (MDD), which may also increase this risk (Vancampfort et al., 2015). Cardiometabolic disease and its sequelae lead to diminished quality of life, and also contribute substantially to the PTSD-associated excess mortality rate, which is 2–3 times higher than the general population (Ahmadi et al., 2011; Schlenger et al., 2015).
Lower health related quality of life in U.S. military personnel is associated with service-related disorders and inflammation
2014, Psychiatry ResearchCitation Excerpt :Although HTN is not necessarily a service-related disorder, it is linked to service-related disorders such as depression and PTSD, in particular. The relationship between HTN and depression and PTSD has been found in a variety of study populations including civilians in war zones and women who have never been exposed to combat (Boscarino, 2012). Additionally, previous research has demonstrated that early treatment intervention after trauma improves clinical anxiety outcomes in trauma-exposed individuals, and these findings have implications in reducing the risk of cardiovascular disease (Boscarino et al., 2006).
Objective evidence of myocardial ischemia in patients with posttraumatic stress disorder
2013, Biological PsychiatryCitation Excerpt :As the first study to evaluate PTSD and CVD using ETT, our findings provide important validation of the association of PTSD and increased CVD risk. Determining the mechanisms responsible for the association of PTSD and CVD was recently identified as a key direction for new research, and our study was able to examine a variety of potential biological, behavioral, and psychosocial mediators (37). Consistent with prior studies that included data on traditional CVD risk factors, we found these explained only a minor portion of the association and therefore explored several additional potential mechanisms (8,15).
Posttraumatic stress disorder and risk for coronary heart disease: A meta-analytic review
2013, American Heart JournalPosttraumatic Stress Disorder and Cardiovascular Disease
2013, Progress in Cardiovascular DiseasesCitation Excerpt :The effect sizes they reported have ranged from a hazard ratio for incident CVD and/or cardiac mortality of 1.46 to 3.28. Given the consistent findings of these studies on PTSD and CVD, attention has turned to understanding the pathologic mechanisms that connect these two disorders.3 Several studies have found the association of PTSD and CVD to be independent of traditional CVD risk factors, such as hypertension, diabetes, and dyslipidemia.6
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Source of funding: Supported in part by a grant from the National Institute of Mental Health (Grant # R21-MH-086317), Boscarino PI.