Women with symptoms of posttraumatic stress disorder (PTSD) may be at an increased risk for heart attacks and strokes, suggests a new study.
Women with the most symptoms were about 60 percent more likely to develop cardiovascular disease, compared to women who never experienced trauma, researchers report in the American Heart Association journal Circulation.
"Women who have PTSD should be aware they are at increased risk of cardiovascular disease or stroke," said Jennifer Sumner, the study's lead author from the Columbia University Mailman School of Public Health in New York.
She also said doctors treating women with PTSD should take note of their cardiovascular risk factors.
PTSD can occur after a traumatic experience. People with PTSD may relive the trauma, avoid certain situations, be overly aware in certain situations or become emotionally numb.
About 10 percent of women are thought to develop PTSD over their lifetimes, compared to about 5 percent of men, the researchers write.
PTSD has been linked to cardiovascular disease before, but most studies have involved male military veterans, Sumner told Reuters Health.
For the new study, the researchers used data on close to 50,000 female nurses whose health was tracked for over 20 years, starting in 1989 when they were 25 to 42 years old.
During that time, the women had 277 heart attacks and 271 strokes.
In 2008, the women were sent questionnaires about their exposure to traumatic events and seven potential symptoms of PTSD. These symptoms included, for example, staying away from places or activities that are reminders of the traumatic event, or losing interest in activities that were once important or enjoyable, or finding it hard to feel love or affection, or becoming jumpy or easily startled by ordinary noises or movements – with these symptoms and others persisting long after the traumatic event occurred.
The researchers found that being exposed to a seriously traumatic event without having symptoms of PTSD was linked to a 45 percent increased risk of having a heart attack or stroke, compared to those not exposed to trauma.
Among women who reported four or more symptoms of PTSD, the risk of having a heart attack or stroke was 60 percent greater than among women who never experienced trauma.
After adjusting the results for the women's health behaviors, the researchers found that about half of the association between PTSD symptoms and the increased risk could be explained by weight, cigarette and alcohol use, physical activity and diet.
"Right now it’s not routine practice for people with PTSD to be screened for heart risk factors, and we hope this is something that might change," Sumner said.
She also said PTSD may lead to actual changes within the body that put women at higher risk for cardiovascular disease.
"We tried to conceptualize it as two potential pathways," she said.
The heart attacks and strokes observed in this study are considered "early onset," because the women were so young, Sumner said. She added that they will continue to follow the women's health.
"We’re very interested in looking at interventions that treat PTSD and see if that reduced cardiovascular risk," she said.