Posttraumatic Stress Disorder Is Associated With Worse Endothelial Function Among Veterans

Area of Science:

• Behavioral Cardiology
• Vascular Biology
• Psychiatry

Background:

• Behavioral cardiology research indicates a strong link between posttraumatic stress disorder (PTSD) and elevated cardiovascular disease (CVD) risk and mortality.
• The precise biological mechanisms underlying this association remain largely unexplored.
• Endothelial dysfunction is a potential pathway connecting PTSD to CVD development and progression.

Purpose of the Study:

• To investigate whether patients with PTSD exhibit endothelial dysfunction.
• To explore the association between PTSD and impaired endothelial function as a potential CVD mechanism.

Main Methods:

• A cohort of 214 outpatients were assessed for PTSD using the PTSD Checklist (based on DSM-IV criteria, score ≥40).
• Endothelial function was evaluated using flow-mediated vasodilation (FMD) of the brachial artery.
• Multivariable linear regression models were employed to analyze the relationship between PTSD status and FMD, adjusting for covariates.

Main Results:

• Patients with PTSD (n=67) demonstrated significantly lower FMD compared to those without PTSD (5.8±3.4% vs. 7.5±3.7%, P=0.003).
• In multivariable analysis, PTSD remained independently associated with worse endothelial function (P=0.0005).
• Lower FMD was also associated with older age, lower estimated glomerular filtration rate, hypertension, and certain medications.

Conclusions:

• Posttraumatic stress disorder (PTSD) is independently associated with endothelial dysfunction in an outpatient population, even after adjusting for demographic, comorbidity, and treatment factors.
• This finding suggests that impaired endothelial function may be a contributing mechanism to the increased cardiovascular disease risk observed in individuals with PTSD.
• Further research is warranted to confirm if endothelial dysfunction mediates the higher CVD risk in PTSD patients.