In a study of hundreds of VA patients from Northern California published online in the Journal of Biological Psychiatry, NCIRE researchers at the San Francisco VA Medical Center have found significant cardiovascular differences in patients diagnosed with Post-Traumatic Stress Disorder (PTSD) than patients without PTSD.
Beth Cohen, MD, MAS, Assistant Professor of Medicine at the University of California, San Francisco (UCSF) and staff physician at San Francisco VA Medical Center (SFVAMC), led the investigation into the physiological connection between cardiovascular health and PTSD in Veterans. The “Mind Your Heart Study,” based at SFVAMC, is an ongoing project aimed at understanding how PTSD impacts the body.
In the publication, 663 VA patients from the San Francisco and Palo Alto VA Medical Centers enrolled in the study were studied via continuous electrocardiogram (EKG) on an exercise treadmill test. The EKG results were evaluated for changes suggestive of ischemia – a decrease in blood supply to the heart that can lead to heart attacks and negative cardiac events.
The study found that patients with PTSD were more than twice as likely to have ischemia on the exercise test, even after researchers controlled for traditional heart disease risk factors, lifestyle behaviors, social support and depression. Though links between psychological stress and physical health have been examined and established in past research, Dr. Cohen’s findings go a step further, providing compelling, objective evidence of the strong physiological relationship between PTSD and heart disease.
The study contributes important new data to a growing research literature that shows the marked impact of chronic stress on cardiac health. In a recent study of Vietnam Veteran twin pairs by Dr. Viola Vaccarino and colleagues at Emory University, Veterans with PTSD were found to have decreased myocardial blood flow on nuclear imaging and higher incidence of coronary heart disease than Veterans without PTSD. Both studies represent unique and detailed examinations of the relationship between traumatic stress and ischemic heart disease in large numbers of Veterans.
“This work shows linkage between PTSD and heart disease in an objective, physiological framework,” says Dr. Cohen. “Qualitative self-report studies are important, and have guided much of the work we are doing today. But finding strong associations in studies using objective measures should add validation to the experiences of Veterans who have long noted a connection between their mental and physical health.”
“Of course, these results bring up more questions. We know that the body changes when the mind is taxed with chronic stress, but we need to know more about the mechanisms behind those changes. We want to know more about precisely how this is happening so we can develop new and tailored treatments for Veterans, and for anyone with PTSD that can improve their long term health.”
Co-authors of the study are Drs. Jesse Turner, Thomas Neylan, Nelson Schiller, and Yongmei Li.
This work was supported by grants from the National Heart, Lung, and Blood Institute, the Irene Perstein Foundation, the American Heart Association Clinical Research Program, and the University of California, San Francisco.
NCIRE - The Veterans Health Research Institute - is the largest research institute associated with a VA medical center. Its mission is to improve the health and well-being of Veterans and the general public by supporting a world-class biomedical research program conducted by the UCSF faculty at SFVAMC.
SFVAMC has the largest medical research program in the national VA system, with more than 200 research scientists, all of whom are faculty members at UCSF.
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.