Post-Traumatic Stress Disorder (PTSD) and Cardiovascular Diseases: A Systematic Review and Meta-Analysis

Introduction Post-traumatic stress disorder ( PTSD ) is a psychiatric condition characterized by intrusive memories, avoidance, negative mood alterations, and hyperarousal following trauma. Beyond its psychological burden, PTSD exerts multisystemic effects, including autonomic dysregulation, hypothalamic–pituitary–adrenal axis imbalance, inflammation, and health-risk behaviors, which increase cardiovascular disease ( CVD ) risk. Conversely , acute cardiac events can themselves precipitate PTSD , suggesting a bidirectional relationship. Objectives This meta-analysis examined: (1) the risk of incident CVD among individuals with PTSD , and (2) the prevalence of PTSD in patients with CVD Methods Following PRISMA guidelines, PubMed, Scopus, and Web of Science were searched up to May 2025. Eligible studies included observational or interventional human research reporting CVD incidence in PTSD or PTSD prevalence following CVD . Effect sizes were pooled using random-effects models. Heterogeneity was assessed with Q, I², and τ². Publication bias was evaluated with funnel plots and Egger’s test. Results Twenty-nine studies ( n ≈ 2.7 million ) met inclusion. Eighteen assessed CVD risk in PTSD populations (n ≈ 2.6 million). Pooled analysis showed PTSD increased CVD risk by 75% (log RR = 0.56, 95% CI = 0.42–0.69; p < 0.0001). Eleven studies (n ≈ 148,000) reported PTSD prevalence following CVD , with pooled estimates indicating 25.3% (95% CI = 0.19–0.31) of cardiac patients met diagnostic criteria or exhibited clinically significant PTSD symptoms. Both directions showed substantial heterogeneity but consistent effects across study designs and populations. Image 1: Image 1: Long description. Image 2: Image 2: Long description. Image 3: Image 3: Long description. Conclusions PTSD and CVD are reciprocally linked. PTSD substantially elevates cardiovascular risk, while cardiovascular events act as potent psychological stressors, frequently triggering PTSD . These findings highlight the need for integrated care: trauma-informed strategies in cardiology and cardiovascular risk monitoring in psychiatric practice. Early identification and multidisciplinary interventions may help disrupt this pathological cycle and improve long-term prognosis. Disclosure of Interest None Declared