Key result
Small and large PTSD symptom improvements were non-associated with lower incident hypertension risk and showed no association with hyperlipidemia or weight loss.
Why the study?
PTSD is linked to cardiometabolic disease, but whether clinically meaningful PTSD improvement is associated with incident hypertension, hyperlipidemia, and weight loss remains unknown.
Does clinically meaningful PTSD symptom improvement reduce the risk of incident hypertension and hyperlipidemia or increase the likelihood of >=5% weight loss in veterans with PTSD?
Cohort (n=979)
Yes
Does clinically meaningful PTSD symptom improvement reduce the risk of incident hypertension and hyperlipidemia or increase the likelihood of >=5% weight loss in veterans with PTSD?
Clinically meaningful PTSD symptom reduction showed a non-significant trend toward lower incident hypertension risk but was not associated with reduced hyperlipidemia risk or >=5% weight loss among veterans.
Answers are grounded in this paper and cite their sources.
Direct cardiometabolic management remains necessary even when PTSD symptoms improve; leaves open whether psychiatric recovery alone modifies incident cardiovascular risk.
OBJECTIVE: Posttraumatic stress disorder (PTSD) is associated with increased risk for cardiometabolic disease. Clinically meaningful PTSD improvement is associated with a lower risk for diabetes, but it is not known if similar associations exist for incident hypertension, hyperlipidemia, and clinically relevant weight loss (i.e., ≥5% loss). METHOD: Medical record data from Veterans Health Affairs patients with clinic encounters between fiscal year (FY) 2008 to 2015 were used to identify patients with worsening or no PTSD improvement (i.e., PTSD checklist (PCL) score decrease <10), small (10-19 point PCL decrease), and large (≥20 point PCL decrease) PTSD improvement. To estimate the association between degree of PTSD improvement and incident hypertension (n = 979), incident hyperlipidemia (n = 1,139) and incident ≥5% weight loss (1,330), we computed Cox proportional hazard models, controlling for confounding using inverse probability of exposure weighting (IPEW). RESULTS: Overall, patients were about 40 years of age, 80% male and 65% White. Worsening or no PCL change occurred in about 60%, small improvement in 20%, and large improvement in 20%. After weighting data, compared with worsening or no change, both small and large PTSD improvements were associated, albeit not significantly, with lower risks for hypertension (HR = 0.68; 95% confidence interval, CI [0.46, 1.01] and HR = 0.79; 95% CI [0.53, 1.18], respectively). In weighted data, PTSD improvement was not associated with incident hyperlipidemia or ≥5% weight loss. CONCLUSIONS: We observed limited evidence for an association between PTSD improvement and decreased hypertension risk. PCL decreases were not associated with hyperlipidemia or ≥5% weight loss. Further studies that measure potential physical health benefits of change in specific PTSD symptoms are needed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Scherrer et al. (2020) conducted a cohort in Posttraumatic stress disorder (PTSD) (n=979). Small (10-19 point PCL decrease) or large (>=20 point PCL decrease) PTSD symptom improvement vs. Worsening or no PTSD improvement (<10 point PCL decrease) was evaluated on Incident hypertension (HR 0.68 (small improvement); HR 0.79 (large improvement), 95% CI 0.46-1.01). Small and large PTSD symptom improvements were non-associated with lower incident hypertension risk and showed no association with hyperlipidemia or weight loss.
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