War injuries, PTSD can double risk of hypertension

War injuries and subsequent post-traumatic stress disorder (PTSD) have been found to double the risk for high blood pressure, according to a study published online March 19 in Hypertension.

PTSD had previously been linked to negative outcomes including substance abuse, weight gain, obesity, coronary artery disease, hypertension and mortality.

Researchers of this study sought to estimate the prevalence and incidence of PTSD within a severely injured military cohort, assess the association between PTSD and hypertension, and determine if the initial injury “severity score” and PTSD are independent risk factors for hypertension.

The study cohort included 3,846 U.S. military members who were injured in Iraq and Afghanistan between Feb. 2002 and Feb. 2011. The overall prevalence of PTSD in the cohort was 42 percent, and more than 14 percent had developed high blood pressure at least 90 days after being wounded.

Notable findings included:

• For every five-point increase in the 75-point Injury Severity Score, the overall risk of high blood pressure was elevated by 5 percent.
• Those who had an Injury Severity Score of 25 or lower and no PTSD diagnosis had the lowest hypertension risk of the cohort.
• Patients who had chronic PTSD (between one and 15 diagnoses) had an 85 percent increase in the risk of hypertension.

“We previously reported that combat injury severity is associated with increased long-term risk of hypertension in injured service members, among other chronic conditions,” wrote lead author Major Ian J. Stewart, MD, with David Grant USAF Medical Center, Travis Air Force Base in California, and colleagues. “The risk of long-term morbidity could arise through multiple possible pathways. It is possible that the effect of the initial injury severity is mediated by the development of PTSD. In this case, increased injury severity is associated with higher risk of PTSD, which becomes the pathway through which hypertension arises."