Key result
Autonomic reactivity to negative emotional scripts significantly predicted impaired flow-mediated dilation in young, physically healthy combat veterans, correctly classifying 76.5% of cases.
Cross-Sectional (n=24)
Yes
p-value: p=0.010
In physically healthy combat veterans, autonomic reactivity to emotional stimuli is associated with impaired endothelial function, highlighting the potential need for cardiovascular screening in this population.
Hypothesis-generating for PTSD-autonomic links to veteran cardiovascular risk; larger prospective studies needed before clinical translation.
Posttraumatic stress disorder (PTSD), and combat-related PTSD in particular, has been associated with increased rates of cardiovascular disease, and cardiovascular-related death. However, less research has examined possible factors that may link PTSD to poorer cardiovascular health in combat veteran populations. The current pilot study investigated whether psychological symptomology and autonomic reactivity to emotional scripts would relate to poorer cardiovascular health in combat veterans without a current diagnosis of cardiovascular disease. Male veterans (N = 24), who served in combat since Operation Iraqi Freedom, completed a semi-structured interview and self-report measures to assess psychological symptomology. Autonomic reactivity, measured using heart rate variability (HRV; low to high frequency ratio), was obtained during script-driven imagery of emotional memories. Cardiovascular health was assessed using flow-mediated dilation (FMD) of the brachial artery. Correlational analyses and discriminant analysis were used to assess the relationship between psychological symptoms (PTSD, depression, anger, as measured via self-report), autonomic reactivity to emotional scripts (HRV), and FMD. Overall, veterans in the current study showed poor cardiovascular health despite their relatively young age and lack of behavioral risk factors, with 15/24 exhibiting impaired FMD (FMD < 5%). Psychological symptomology was not associated with FMD; whereas autonomic reactivity to emotional (compared to neutral) scripts was found to relate to FMD. Autonomic reactivity to negative scripts correctly classified 76.5% of veterans as having impaired versus normative FMD. Results from this pilot study highlight the importance of cardiovascular screening with combat veterans despite psychological diagnosis. Results also support the need for longitudinal research assessing the use of autonomic reactivity to emotionally valenced stimuli as a potential risk factor for poorer cardiovascular health.
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Clausen et al. (2016) conducted a cross-sectional in Combat Veterans with varying levels of PTSD (n=24). Autonomic reactivity to negative emotional scripts was evaluated on Impaired flow-mediated dilation (FMD < 5%) (p=0.010). Autonomic reactivity to negative emotional scripts significantly predicted impaired flow-mediated dilation in young, physically healthy combat veterans, correctly classifying 76.5% of cases.
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