Post-traumatic Stress Disorder, Coronary Atherosclerosis, and Mortality
Abstract
Post-traumatic stress disorder (PTSD) is associated with increased risk of multiple medical problems including myocardial infarction. However, a direct link between PTSD and atherosclerotic coronary artery disease (CAD) has not been made. Coronary artery calcium (CAC) score is an excellent method to detect atherosclerosis. This study investigated the association of PTSD to atherosclerotic CAD and mortality. Six hundred thirty-seven veterans without known CAD (61 ± 9 years of age, 12.2% women) underwent CAC scanning for clinical indications and their psychological health status (PTSD vs non-PTSD) was evaluated. In subjects with PTSD, CAC was more prevalent than in the non-PTSD cohort (76.1% vs 59%, p = 0.001) and their CAC scores were significantly higher in each Framingham risk score category compared to the non-PTSD group. Multivariable generalized linear regression analysis identified PTSD as an independent predictor of presence and extent of atherosclerotic CAD (p 0 compared to subjects without PTSD and CAC score equal to 0. With a CAC score equal to 0, risk of death was not different between subjects with and without PTSD (RR 1.04, 95% CI 0.67 to 6.82, p = 0.4). Risk of death in each CAC category was higher in subjects with PTSD compared to matched subjects without PTSD (RRs 1.23 for CAC scores 1 to 100, 1.51 for CAC scores 101 to 400, and 1.81 for CAC scores ≥400, p <0.05 for all comparisons). In conclusion, PTSD is associated with presence and severity of coronary ather…
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The association of PTSD and CVD is confirmed by objective tests of cardiovascular health and function such as nuclear imaging.
“and confirmed the association of PTSD and CVD by using objective tests of cardiovascular health and function such as nuclear imaging. 28-30”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [30]
Adults with a greater sense of purpose have more favorable lifestyle and cardiovascular risk factors such as less smoking, more physical activity, less alcohol and substance abuse, and better glucose control.
“Similar to optimistic adults, adults with a greater sense of purpose have more favorable lifestyle and cardiovascular risk factors such as less smoking, 70 more physical activity, 30 less alcohol and substance abuse, and better glucose control. 71”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [30]
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- Authors
- Ahmadi, N., Hajsadeghi, F., Mirshkarlo, H. B., Budoff, M., Yehuda, R., & Ebrahimi, R.
- Affiliations
- University of California, Los Angeles (US)
- James J. Peters VA Medical Center (US)
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 108
- Issue
- 1
- Pages
- 29-33
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2002514645
- Cited by
- 257
- References
- 2
- Citations by year
- 2026: 6 · 2025: 18 · 2024: 16 · 2023: 6 · 2022: 7 · 2021: 17 · 2020: 21 · 2019: 15 · 2018: 18 · 2017: 23 · 2016: 26 · 2015: 22 · 2014: 21 · 2013: 26 · 2012: 8
- FWCI
- 13.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- post-traumatic stress disorder, coronary artery calcium, coronary artery disease, mortality, veterans, cardiovascular risk, Framingham risk score, myocardial infarction, sex differences in mortality
- MeSH terms
- Calcium, California, Coronary Artery Disease, Coronary Vessels, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Stress Disorders, Post-Traumatic, United States, Survival Rate, Confidence Intervals, Odds Ratio
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