By AMERICAN HEART ASSOCIATION NEWS
Women who experience traumatic events or develop post-traumatic stress disorder may have a greater risk of heart attacks and strokes than women without such a history, according to new research.
The study, published in the American Heart Association’s journal Circulation, is the largest to examine PTSD and cardiovascular disease in women. PTSD is twice as common in women as in men.
“PTSD is generally considered a psychological problem, but the take-home message from our findings is that it also has a profound impact on physical health, especially cardiovascular risk,” said the study’s lead author Jennifer Sumner, Ph.D., a clinical psychologist at Columbia University’s Mailman School of Public Health and a visiting scientist at Harvard’s T.H. Chan School of Public Health.
“This is not exclusively a mental problem — it’s a potentially deadly problem of the body as well,” she said.
PTSD occurs in some people after traumatic events, such as a natural disaster, unwanted sexual contact or physical assault. It is characterized by flashbacks of the trauma, insomnia, fatigue, trouble remembering or concentrating and emotional numbing. Other symptoms include nightmares, flashbacks, irritability or being startled easily.
In the federally funded study, researchers examined about 50,000 women under age 65 in the Nurses’ Health Study II. They found that after two decades, women with four or more PTSD symptoms had 60 percent higher rates of cardiovascular disease compared to women who were not exposed to traumatic events. Even for women who reported traumatic events but no PTSD symptoms, rates of cardiovascular disease were still 45 percent higher.
Almost half of the association between elevated PTSD symptoms and cardiovascular disease was due to unhealthy behaviors such as smoking, obesity, lack of exercise and medical issues such as high blood pressure.
PTSD first came to prominence after the Vietnam War. Much of the research since then has been funded by the National Institutes of Health and the U.S. Department of Veterans Affairs.
“Given the increasing number of veterans in the U.S., the well-being of military personnel has been a growing public health concern,” Sumner said.
So when earlier studies started to hint that PTSD was a health threat, interest grew in understanding just how widespread the effects of trauma and PTSD were on health.
“There have been more studies in recent years on the effects of PTSD on a number of physical health outcomes, such as cardiovascular diseases and Type 2 diabetes, but also health behaviors such as smoking and obesity,” Sumner said.
Most studies of cardiovascular disease risk in PTSD patients have been conducted in male war veterans or among disaster survivors.
Karestan Koenen, Ph.D., the study’s senior author, said PTSD patients need access to integrated mental and physical health care.
“The medical system needs to stop treating the mind and the body as if they are separate,” said Koenen, an epidemiology professor at Mailman School of Public Health and T.H. Chan School of Public Health.
Researchers used a questionnaire to evaluate different types of traumatic experiences and PTSD symptoms. They considered cardiovascular disease risk factors such as obesity, lack of exercise, diabetes, cigarette smoking and high blood pressure, as well as other contributors to cardiovascular health such as excessive alcohol and hormone replacement use.
More than half of Americans with PTSD don’t get treatment, especially minorities. Women with PTSD need to get mental health care to treat symptoms and should also be monitored for signs of heart-related problems, Sumner said.