Orthostatic hypotension in young adults with and without posttraumatic stress disorder

The purpose of this research is (a) to evaluate differences in orthostatic hypotension (OH) among young adults with and without posttraumatic stress disorder (PTSD) and (b) to examine whether group differences may be attributable to behavioral risk factors frequently associated with PTSD. Volunteers and U.S. veterans 18 to 39 years old (N = 222) completed a semistructured interview assessment of PTSD status. Direct measurements were obtained for supine and standing systolic and diastolic blood pressure at study visits, as well as height and weight, from which body mass index (BMI) was calculated. After controlling for use of psychotropic medications, a logistic regression model revealed that PTSD status was positively associated with OH, such that participants with PTSD were at 4.51 greater odds of having OH than control participants. Moreover, this effect was partially mediated by lifetime alcohol dependence (bootstrapped 95% confidence interval [-0.83, -0.20]). Overall, PTSD may pose a significant risk for OH among younger adults. In the present sample, this relationship was primarily driven by the disproportionately high history of alcohol dependence among individuals with PTSD. These results suggest that traditional therapy for PTSD should be coupled with treatment for alcohol dependency, when applicable, to reap both psychological and physiological benefits.