Mind/Body Connection

PTSD, traumatic experiences may raise heart attack, stroke risk in women

Women who experience traumatic events or develop post-traumatic stress disorder may have a greater risk of heart attacks and strokes than women without such a history, according to new research.

The study, published in the American Heart Association’s journal Circulation, is the largest to examine PTSD and cardiovascular disease in women. PTSD is twice as common in women as men.

“PTSD is generally considered a psychological problem, but the take-home message from our findings is that it also has a profound impact on physical health, especially cardiovascular risk,” said the study’s lead author Jennifer Sumner, Ph.D., a clinical psychologist at Columbia University’s Mailman School of Public Health.

PTSD occurs in some people after traumatic events, such as a natural disaster, unwanted sexual contact or physical assault. It is characterized by insomnia, fatigue, trouble remembering or concentrating, emotional numbing and flashbacks of the trauma. Other symptoms include nightmares, flashbacks, irritability or being startled easily.

Researchers examined about 50,000 women under age 65 in the Nurses’ Health Study II. They found that after two decades, women with four or more PTSD symptoms had 60 percent higher rates of cardiovascular disease compared to women who were not exposed to traumatic events. Even for women who reported traumatic events but no PTSD symptoms, rates of cardiovascular disease were still 45 percent higher.

Almost half of the association between elevated PTSD symptoms and cardiovascular disease was due to unhealthy behaviors such as smoking, obesity, lack of exercise and medical issues such as high blood pressure.

“There have been more studies in recent years on the effects of PTSD on a number of physical health outcomes, such as cardiovascular diseases and Type 2 diabetes, but also health behaviors such as smoking and obesity,” Sumner said.

Karestan Koenen, Ph.D., the study’s senior author, said PTSD patients need access to integrated mental and physical health care.

“The medical system needs to stop treating the mind and the body as if they are separate,” said Koenen, an epidemiology professor at Mailman School of Public Health and T.H. Chan School of Public Health.

More than half of Americans with PTSD don’t get treatment, especially minorities. Women with PTSD need to get mental health care to treat symptoms and should also be monitored for signs of heart-related problems, Sumner said.

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