Understanding how PTSD raises heart disease risk

Post-traumatic stress disorder (PTSD) is associated with increased levels of two coagulation (clotting) factors and may thereby promote atherosclerosis (hardening of the arteries) and increase the risk of cardiovascular disease, investigators say.

Several studies have demonstrated the increased cardiovascular risk associated with PTSD, even years after the trauma. Suggested mediators of this relationship include unhealthy lifestyle, chronic low-grade inflammation, and blood clotting activation, but until now no one had investigated any link between PTSD and a "hypercoagulable" state.

To that end, Dr. Roland von Kanel from University Hospital Berne in Switzerland, and his team recruited 14 adults diagnosed with chronic PTSD and 14 control subjects matched by gender and age who had also experienced a traumatic event but were not diagnosed with PTSD.

The levels of specific PTSD symptoms (re-experiencing, avoidance, and hyperarousal) as well as depression and anxiety were assessed by interview. From blood samples, the investigators measured blood levels of several clotting factors.

The team reports in the journal Psychosomatic Medicine that coagulation factor levels did not differ significantly between the two groups.

However, among all 28 subjects, hyperarousal severity and PTSD symptom severity were associated with one specific clotting factor known as FVIII:C.

Also, in the PTSD group alone, hyperarousal and PTSD symptom scores were associated with levels of the coagulation factor fibrinogen, although the association was attenuated after controlling for depression and anxiety.

The team concludes that symptoms associated with PTSD could lead to a hypercoagulable state, which "could be of particular clinical importance in terms of an elevated cardiovascular risk and overall mortality several years down the line."

SOURCE: Psychosomatic Medicine July/August 2006.