Higher predeployment LF:HF ratios (lower heart rate variability) were associated with an increased risk of postdeployment PTSD diagnosis in active-duty Marines (OR 1.47; 95% CI 1.10-1.98; P=0.01).
Cohort (n=2,160)
Does lower predeployment heart rate variability increase the risk of postdeployment PTSD in active-duty Marines?
Lower heart rate variability before combat deployment is associated with an increased risk of developing PTSD after deployment in active-duty Marines.
Odds Ratio: 1.47 (95% CI 1.1–1.98)
Tasa de eventos absoluta: 15.8% vs 3.7%
valor p: p=.01
IMPORTANCE: Disrupted autonomic nervous system functioning as measured by heart rate variability (HRV) has been associated with posttraumatic stress disorder (PTSD). It is not clear, however, whether reduced HRV before trauma exposure contributes to the risk for development of PTSD. OBJECTIVE: To examine whether HRV before combat deployment is associated with increased risk of a PTSD diagnosis after deployment when accounting for deployment-related combat exposure. DESIGN, SETTING, AND PARTICIPANTS: Between July 14, 2008, and May 24, 2012, active-duty Marines were assessed 1 to 2 months before a combat deployment and again 4 to 6 months after their return. The first phase of the Marine Resiliency Study (MRS-I) included 1415 male Marines, 59 of whom developed PTSD after deployment. Participants in the second phase of the Marine Resiliency Study (MRS-II) included 745 male Marines, 25 of whom developed PTSD after deployment. Analysis was conducted from November 25, 2013, to April 16, 2015. MAIN OUTCOMES AND MEASURES: Predeployment HRV was measured via finger photoplethysmography during a 5-minute period of rest. Frequency-domain measures of HRV were generated. Diagnosis of PTSD was determined using the Clinician-Administered PTSD Scale. RESULTS: After accounting for deployment-related combat exposure, lower HRV before deployment as measured by an increased low-frequency (LF) to high-frequency (HF) ratio of HRV was associated with risk of PTSD diagnosis after deployment (combined MRS-I and MRS-II cohort meta-analysis odds ratio, 1.47; 95% CI, 1.10-1.98; P = .01). The prevalence of postdeployment PTSD was higher in participants with high predeployment LF:HF ratios (15.8% 6 of 38 participants) compared with participants who did not have high LF:HF ratios (3.7% 78 of 2122 participants). CONCLUSIONS AND RELEVANCE: This prospective longitudinal study provides initial and modest evidence that an altered state of autonomic nervous system functioning contributes to PTSD vulnerability, taking into account other key risk factors. If these findings are replicated, interventions that change autonomic nervous system function may open novel opportunities for prevention and treatment of PTSD.
Minassian et al. (Wed,) conducted a cohort in Posttraumatic stress disorder (PTSD) (n=2,160). High predeployment LF:HF ratio (lower heart rate variability) vs. No high LF:HF ratio was evaluated on Diagnosis of PTSD after deployment (OR 1.47, 95% CI 1.10-1.98, p=.01). Higher predeployment LF:HF ratios (lower heart rate variability) were associated with an increased risk of postdeployment PTSD diagnosis in active-duty Marines (OR 1.47; 95% CI 1.10-1.98; P=0.01).