Key result
Avoidance behaviours were associated with greater systolic blood pressure (AC 0.640), while other PTSD symptom clusters were linked to cardiometabolic and haemodynamic changes but not inflammation.
Why the study?
PTSD is an independent risk factor for cardiovascular disease, but the mechanisms underlying this relationship are not well understood.
Are PTSD symptom clusters associated with mechanisms of cardiovascular disease in male UK military personnel?
Cross-Sectional (n=1,111)
Are PTSD symptom clusters associated with mechanisms of cardiovascular disease in male UK military personnel?
Specific PTSD symptom clusters are associated with distinct cardiometabolic and haemodynamic risk factors, suggesting targeted pathways linking PTSD to cardiovascular disease.
Answers are grounded in this paper and cite their sources.
Avoidance symptoms in PTSD associate with higher systolic BP in military personnel; hypothesis-generating for symptom-specific pathways, not yet practice-changing.
Post-Traumatic Stress Disorder (PTSD) has been identified as an independent risk factor for cardiovascular disease, but the mechanisms of this relationship are not well understood. This study investigates the associations between PTSD symptom clusters (hyperarousal, intrusive thoughts, avoidance behaviours and emotional numbing) and mechanisms of cardiovascular disease including cardiometabolic effects, inflammation, and haemodynamic functioning. In the ADVANCE study cohort of UK male military personnel, 1111 participants were assessed for PTSD via questionnaire and cardiovascular risk via venous blood sampling, pulse wave analysis and dual energy x-ray absorptiometry between 2015 and 2020. Variable selection procedures were conducted to assess which of the symptom clusters if any were associated with cardiovascular risk outcomes. Associations were confirmed via robust regression modelling. Avoidance behaviours were associated with greater systolic Blood Pressure (BP) (Adjusted Coefficient (AC) 0.640 (95% Confidence Interval (CI) 0.065, 1.149). Emotional numbing was associated with greater estimated glucose disposal rate (AC -0.021 (95%CI -0.036, -0.005). Hyperarousal was associated with greater levels of (log)triglycerides (exponentiated-AC 1.009 (95%CI 1.002, 1.017). Intrusive thoughts were associated with greater visceral adipose tissue (AC 0.574 (95%CI 0.020, 1.250). Nonlinear relationships were observed between emotional numbing with heart rate and intrusive thoughts with systolic BP. Limited evidence is present for symptom associations with lipoproteins and pulse wave velocity. No associations were observed between PTSD symptom clusters and high sensitivity c-reactive protein, diastolic BP, total cholesterol, or haemoglobin fasting glucose. In conclusion, symptom clusters of PTSD were associated with increased cardiovascular risk via cardiometabolic and haemodynamic functioning mechanisms, but not inflammation.
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Dyball et al. (2023) conducted a cross-sectional in Post-Traumatic Stress Disorder (PTSD) and Cardiovascular Risk (n=1,111). PTSD symptom clusters (avoidance behaviours, emotional numbing, hyperarousal, intrusive thoughts) vs. Lower symptom severity was evaluated on Systolic blood pressure (associated with avoidance behaviours) (AC 0.640, 95% CI 0.065-1.149). Avoidance behaviours were associated with greater systolic blood pressure (AC 0.640), while other PTSD symptom clusters were linked to cardiometabolic and haemodynamic changes but not inflammation.
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