An increasing body of evidence indicates that posttraumatic stress disorder, a common anxiety disorder in both veteran and nonveteran populations, is associated with major forms of cardiovascular disease including those attributed to atherosclerosis such as coronary heart disease and thromboembolic stroke.
Persons with PTSD have also been reported to be more likely to have hypertension, hyperlipidemia, obesity, and cardiovascular disease . These findings are important to the field of cardiology since coronary heart disease may develop over time as a result of hemodynamic factors (for example, elevated blood pressure with turbulence and sheer stress within coronary arteries), hyperlipidemia, and events such as the rupture of atherosclerotic plaques and thrombus formation .
This review summarizes cardiovascular alterations linked to PTSD including results from epidemiologic and clinical studies and possible biological mechanisms. BACKGROUND Individuals may develop PTSD after being exposed to a traumatic event such as combat experiences, a motor vehicle crash, or sexual assault . Symptoms of PTSD may include nightmares, intrusive thoughts, or other re-experiencing phenomena, the avoidance of situations that remind the person of the traumatic event, a feeling of numbness or being socially detached from family and friends, and hyper-arousal (for example, feeling angry, irritable and “on edge,” or having difficulty concentrating).
Hyper-arousal or hypervigilance includes a rapid and pronounced reaction to stressors which may lead to a preoccupation with signs of threat and emotional distress.
Persons with PTSD may have other challenges such as difficulties with employment, relationships, or other health conditions (for example, depression, alcohol abuse or drug dependency). Effective psychological and medical treatments for PTSD include group or individual psychotherapy (for example, cognitive-behavioral therapy) and pharmacotherapy such as the use of selective serotonin reuptake inhibitors . Cognitive-behavioral therapy helps patients to address their traumatic memories and distorted cognitions (for example, by providing education about the nature of PTSD and stress responses and helping the individual with the integration of the traumatic events).