Abstract MP83: Post-traumatic Stress Disorder Symptoms and Increased Risk of Cardiovascular Disease: What Happens When Symptoms Remit?
Introduction: Women with trauma and post-traumatic stress disorder (PTSD) are at greater risk of cardiovascular diseases (CVD); whether symptom remission is associated with less risk remains unknown.
Hypothesis: Women who experience trauma and developed persistent PTSD will have increased risk of CVD, but those whose symptoms remit will not have increased risk.
Methods: We examined the association between time-updated trauma exposure, PTSD symptoms, and PTSD symptom remission in relation to incident CVD over a 20-year period in 36,958 healthy women in the Nurses’ Health Study II. We used proportional hazards models to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) for CVD events confirmed by additional information or medical record review (n=402; 202 myocardial infarctions and 200 strokes). Trauma exposure was assessed using the Brief Trauma Questionnaire. PTSD symptoms were assessed using Breslau’s PTSD screen; report of 4 or more (out of 7) symptoms was characterized as clinically-relevant PTSD. All models adjusted for age, family history of CVD, and childhood factors. Additional models controlled for health behaviors (smoking, physical activity, drinking, and diet) and medical risk factors (hypertension, Type 2 diabetes, and use of hormone replacement therapy).
Results: Compared to women with no trauma, trauma-exposed women with no PTSD symptoms had elevated CVD risk (HR=2.31; 95% CI 1.79-2.98) as did those with clinically-relevant PTSD (HR=1.84; 95% CI 1.36-2.50). Women with remission of clinically relevant levels of PTSD symptoms were at lower risk of CVD (HR=1.39; 95% CI: 0.88-2.19). Associations of clinically relevant PTSD symptoms (HR=1.59; 95% CI: 1.17, 2.16) and trauma exposure without PTSD symptoms (HR=2.14; 95% CI: 1.65, 2.77) remain significant albeit somewhat attenuated after adjustment for health behaviors and medical conditions.
Conclusions: Trauma exposure and elevated PTSD symptoms may increase the risk of CVD. However, our findings suggest that interventions targeted at alleviating PTSD symptoms may attenuate the associated CVD risk.
Author Disclosures: P. Gilsanz: None. J.A. Sumner: None. A. Winning: None. A.L. Roberts: None. J.C. Agnew-Blais: None. E.B. Rimm: None. K.C. Koenen: None. L.D. Kubzansky: None.
- © 2015 by American Heart Association, Inc.