PTSD—especially from terror attacks—has lasting cardiovascular consequences

Long-term sufferers of post-traumatic stress disorder (PTSD) are at a higher risk for circulatory and metabolic diseases, especially if they’re men, according to research out of Siena, Italy.

First author Fabio Ferretti, MD, and colleagues studied several dozen PTSD patients with the objective of exploring how the type of traumatic event experienced—particularly terrorist attacks (TA)—influences patients’ physical health in concert with their sex and the duration of their trauma.

“Patients with PTSD have an increased risk of developing a variety of organic clinical conditions, including cardiovascular, respiratory, gastroenteric and sleep disorders,” Ferretti and his coauthors wrote in the Journal of Neuroscience Research, where they published their findings Jan. 8. “The association between PTSD and hypertension is well-established, as is a higher risk of developing stroke and cerebrovascular disease in patients with PTSD than in healthy subjects.”

Only a subgroup of those exposed to trauma will develop PTSD, the authors said, but some individuals, like people who had traumatic experiences early in their life, deal with more severe symptoms or have cardiovascular comorbidities, are at a heightened risk for the condition. Recent genetic studies have even found evidence that trauma-associated memory disorders can be passed down through generations via protein transmission.

While literature on the subject isn’t exactly lacking, Ferretti et al. said no studies to date have explored the physical impact of PTSD based on the type of event experienced. That could be an important distinction, especially since a growing body of research suggests human-made and technological disasters like terror attacks have more severe consequences than natural disasters.

“TA represent a typical human-made type of disaster and are among the most powerful of traumatic events due to their psychological consequences,” the team wrote. “It could be hypothesized that TA may have a more traumatic impact because of its unexpected nature, since the individual is not prepared to cope with it and the consequent traumatic feelings.”

For their work, Ferretti and colleagues looked into the association between the type of traumatic event experienced (either TA or “other traumatic event”/OTE), sex and PTSD duration in 84 subjects diagnosed with the condition. Thirty-nine were TA victims, while the remaining 45 patients were victims of OTE.

On average, victims of TA had been experiencing PTSD symptoms for 231 months, or a little over 19 years. The OTE group reported an average 90 months of symptoms—seven and a half years.

Both groups presented with medical issues, but the TA cohort seemed particularly hard-hit. Prevalence of the following conditions were:

  • Metabolic syndrome: 28.2 percent (TA group) vs. 8.9 percent (OTE group)
  • Circulatory diseases: 30.8 percent vs. 11.1 percent
  • Endocrine, nutritional and metabolic diseases: 64.1 percent vs. 51.1 percent
  • Neoplasms: 15.4 percent vs. 2.2 percent
  • Musculoskeletal and connective tissue diseases: 25.6 percent vs. 11.1 percent

When it came to sex, the authors said women showed a higher prevalence of neoplasms than men, but their sex was protective against metabolic syndrome. Conversely, men saw a higher prevalence of circulatory diseases and metabolic syndrome, something Ferretti et al. attributed to symptom duration rather than the type of traumatic event itself.

“The current results seemed to suggest that male patients are more likely to present with a PTSD subtype with medical circulatory and metabolic complications, which could require more complex long-term management,” they wrote. “Clinicians could be more cautious regarding the side effects of psychiatric medication prescribed to this subtype of patients, such as antipsychotics, which can increase the risk for metabolic disorders.”

Ferretti and colleagues said women might present with more oncological symptoms because they’re more likely to smoke cigarettes to cope with stress, while men might present with more cardiovascular disease because they’re more likely to self-medicate with alcohol.

Either way, all PTSD victims should be monitored for neoplasms, circulatory disease and metabolic issues, they wrote.

“The current study expands the present literature and shows that sex and duration of symptoms may have a role in the clinical picture of PTSD, since they may be associated with circulatory and metabolic disorders while the type of traumatic event, specifically a TA, may be associated with neoplasms,” the authors said.

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After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.

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