Post-traumatic Stress Disorder Is Associated With Worse Vascular Function Among Veterans

UCSF News reports on a recent study led by UCSF researchers linking post-traumatic stress to a higher risk for cardiovascular disease and death. The results of the research were reported in the March 2016 issue of the Journal of the American Heart Association. Marlene Grenon, M.D., C.M. Associate Professor in the Division of Vascular & Endovascular Surgery, was the lead author of the paper and played a pivotal role in the research. The paper is the result of a collaborative effort among cardiology, vascular surgery, and psychiatry at the San Francisco VA Health Care System. 

Post-traumatic stress disorder (PTSD) in veterans is associated with worse vascular function, which can increase their risk for cardiovascular disease (CVD) and death, according to researchers at UC San Francisco and the affiliated San Francisco VA Health Care System.

The study, which appears in the March 2016 issue of the Journal of the American Heart Association, found that veterans with PTSD were more likely to have worse endothelial vascular function, which controls the flow of nutrients and toxins from the blood stream to the brain and body, and plays a key role in blood vessel dilation, blood pressure, clotting and inflammation.

“If other studies confirm that patients with PTSD have worse endothelial function, this could be an important target in our efforts to prevent CVD and improve the health of veterans with PTSD,” said senior author Beth Cohen, MD, associate professor of medicine at UCSF Health and SFVAHCS.....

“To our knowledge, this represents the largest cohort measuring endothelial function with flow-mediated vasodilation in patients with PTSD,” said lead author Marlene Grenon, MDCM, associate professor of surgery at UCSF Health and SFVAHCS and investigator in the Vascular Integrated Physiology and Experimental Therapeutics (VIPERx) lab in San Francisco. “The data provide evidence of a clear association between PTSD and vascular function among veterans and illustrate the need to determine the optimal multidisciplinary strategies to treat patients with comorbid PTSD and CVD risk.”

The researchers note that more study in a broader population group is needed to determine whether poor endothelial function contributes to excess risk of CVD in these patients.

Patients with PTSD have a higher rate of cardiovascular events and death, which are not explained through risk factors like blood pressure or cholesterol levels. Dr. Grenon hypothesized that vascular function would impaired in PTSD, most likely through heightened sympathetic nervous system output.

The data in the JAHA paper supports this hypothesis, demonstrating that many of the cardiovascular events and mortality can be explained by poor vasoreactivity, i.e., blood vessels cannot dilate to a demand as in normal subjects. This research could lead to new therapies for PTSD patients that target the improvement of blood vessel function. Future research will look at mechanistic links of the neuro-vascular axis.