Proof that Coronary Artery Disease is Related to PTSD

"We have proof for the first time based on coronary artery calcium that coronary artery disease is related to PTSD [posttraumatic stress disorder]," Dr. Ramin Ebrahimi said at the annual scientific sessions of the American Heart Association.

Full article at: PTSD Linked to Risk for Coronary Disease, Death

By: MITCHEL L. ZOLER, Internal Medicine News Digital Network
12/10/10
FROM THE ANNUAL SCIENTIFIC SESSIONS OF THE AMERICAN HEART ASSOCIATION

Major Finding: People with PTSD had a 2.4-fold increased mortality rate during follow-up compared with those without PTSD.

Data Source: A 10-year, retrospective multivariate analysis of 286,194 U.S. military veterans in Southern California.

Disclosures: Dr. Ebrahimi and Dr. Edmondson said they had no disclosures.

CHICAGO – Patients with posttraumatic stress disorder had an increased prevalence of coronary artery disease as well as an increased risk of death in a retrospective analysis of more than 30,000 patients.

"We have proof for the first time based on coronary artery calcium that coronary artery disease is related to PTSD [posttraumatic stress disorder]," Dr. Ramin Ebrahimi said at the annual scientific sessions of the American Heart Association. "There is a significant association between the presence of PTSD, coronary atherosclerosis, and mortality independent of conventional risk factors."

"PTSD can be viewed, in a preliminary way, as a risk factor. While the findings have not been validated in a prospective, longitudinal study, this was a very large study with 286,000 people including more than 30,000 with PTSD," said Dr. Ebrahimi, codirector of the coronary catheterization laboratory at the VA Greater Los Angeles Healthcare System. "An early, integrative psychological and medical evaluation may be indicated to identify PTSD patients and improve quality of life and clinical outcomes." Studies have not yet examined the role that treatment of PTSD can play in mitigating the severity of coronary atherosclerosis and reducing mortality, Dr. Ebrahimi added.

Although proving a link between PTSD and coronary disease requires more evidence, an immediate message from the results so far is that physicians, especially primary care physicians, should be more aware of the high prevalence of PTSD. "It’s very prevalent, perhaps as high as 10% of the general population," Dr. Ebrahimi said in an interview. In addition, diagnosing PTSD identifies a patient who warrants a more careful assessment for coronary disease, he added.

"Dr. Ebrahimi’s report represents one of the largest studies to date to document a significant relationship between PTSD and mortality," with an effect size roughly comparable to prior reports, commented Donald Edmondson, Ph.D., a psychologist in the Center for Behavioral Cardiovascular Health at Columbia University in New York. "In the context of the full body of research on this topic, the findings are quite convincing," he said in an interview.

While the VA study looked exclusively at military veterans, the findings are likely generalizable to people with PTSD who did not serve in the military, Dr. Ebrahimi said.