Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder

Känel, Roland von; Hepp, Urs; Traber, Rafael; Kraemer, Bernd; Mica, Ladislav; Keel, Marius; Mausbach, Brent T.; Schnyder, Ulrich

doi:10.1016/j.psychres.2006.12.003

Cited by 83 publications

(59 citation statements)

References 51 publications

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“…Higher ADMA levels and pulse wave velocities were shown in CAPD patients with depressive symptoms, which also have been documented in several previous studies in patients with depression who have normal renal function [34,35]. This may suggest that endothelial dysfunction [36] or abnormal nitric oxide biosynthesis [37] in patients with depression might be one potential mechanism underlying the increased prevalence of cardiovascular diseases. …”

Section: Discussionsupporting

confidence: 71%

Association between Depression Symptoms with Inflammation and Cardiovascular Risk Factors in Patients Undergoing Peritoneal Dialysis

Kim

et al. 2010

Nephron Clin Pract

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Despite medical progress, high morbidity and mortality rates, due primarily to cardiovascular diseases, have persisted in patients with end-stage renal disease (ESRD). Recently, nontraditional risk factors, such as inflammation and malnutrition, have been emphasized in the development or progression of atherosclerosis in ESRD patients. Depression, the most common psychological problem in the ESRD population, is also known to be associated with inflammation and malnutrition, suggesting a possible link between depression with inflammation and cardiovascular diseases. The purpose of this study was to investigate the relationship between depression with cardiovascular risk factors and inflammation in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Eighty-one stable CAPD patients were enrolled. Depressive symptoms were assessed with the Beck Depression Inventory. Various cardiovascular risk factors and inflammatory markers were measured. Forty-three patients had depressive symptoms (53.8%). Patients with depressive symptoms showed significantly lower levels of albumin and IL-10, but higher levels of inflammatory markers than patients without depressive symptoms. Left ventricular hypertrophy was also found more frequently and pulse wave velocity and asymmetric dimethylarginine were all significantly increased in patients with depressive symptoms. Depression in CAPD patients was associated with inflammation and cardiovascular risk factors, and might be used as a predictor of cardiovascular diseases.

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Section: Discussionsupporting

confidence: 71%

Association between Depression Symptoms with Inflammation and Cardiovascular Risk Factors in Patients Undergoing Peritoneal Dialysis

Kim

et al. 2010

Nephron Clin Pract

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“…Hypercoagulable states may trigger VTE by increasing the likelihood of clot formation, and longitudinal research that examines the effects of trauma exposure and PTSD on coagulation and fibrinolysis is needed. Increased inflammation and endothelial damage—both of which have been observed in those with elevated PTSD symptoms15, 17—are thought to heighten susceptibility to developing VTE as well 7. Thus, several of the covariates included in the fully adjusted model likely represent additional underlying processes linking trauma/PTSD symptoms to VTE; this is consistent with the attenuation in HRs in the fully adjusted model relative to the minimally adjusted model.…”

Section: Discussionmentioning

confidence: 53%

“…PTSD has been increasingly identified as a cardiovascular risk factor,13 with effects particularly striking in women 14. Furthermore, PTSD has been linked to pathophysiological processes implicated in VTE, including inflammation,15 hypercoagulability,16 and endothelial damage 17. One study suggested that PE incidence was higher after compared with before exposure to a natural disaster, a type of traumatic event commonly associated with psychological distress 18.…”

Section: Introductionmentioning

confidence: 99%

Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women

Sumner

Kubzansky

Kabrhel

et al. 2016

JAHA

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BackgroundTrauma exposure and posttraumatic stress disorder (PTSD) have been linked to myocardial infarction and stroke in women, with biological and behavioral mechanisms implicated in underlying risk. The third most common cardiovascular illness, venous thromboembolism (VTE), is a specific health risk for women. Given previous associations with other cardiovascular diseases, we hypothesized that high levels of trauma and PTSD symptoms would be associated with higher risk of incident VTE in younger and middle‐aged women.Methods and ResultsWe used proportional hazards models to estimate hazard ratios (HRs) and 95% CIs for new‐onset VTE (960 events) over 22 years in 49 296 women in the Nurses’ Health Study II. Compared to no trauma exposure, both trauma exposure and PTSD symptoms were significantly associated with increased risk of developing VTE, adjusting for demographics, family history, and childhood adiposity. Women with the most PTSD symptoms exhibited the greatest risk elevation: trauma/6 to 7 symptoms: HR=2.42 (95% CI, 1.83–3.20); trauma/4 to 5 symptoms: HR=2.00 (95% CI, 1.55–2.59); trauma/1 to 3 symptoms: HR=1.44 (95% CI, 1.12–1.84); trauma/no symptoms: HR=1.72 (95% CI, 1.43–2.08). Results were similar, although attenuated, when adjusting for VTE‐relevant medications, medical conditions, and health behaviors.ConclusionsWomen with the highest PTSD symptom levels had nearly a 2‐fold increased risk of VTE compared to women without trauma exposure in fully adjusted models. Trauma exposure alone was also associated with elevated VTE risk. Trauma and PTSD symptoms may be associated with a hypercoagulable state. Treatment providers should be aware that women with trauma exposure and PTSD symptoms may be vulnerable to VTE.

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“…PTSD has a continuous relationship with indices of endothelial dysfunction, such as soluble tissue factor and von Willebrand factor [165]. PTSD is associated with higher levels of circulating cellular adhesion molecules, greater PTSD severity correlating with significantly higher resting levels of soluble vascular cellular adhesion molecule-1 and soluble P-selectin [166].…”

Section: Cardiovascular Disease and Mortalitymentioning

confidence: 99%

Posttraumatic Stress Disorder and Cardiometabolic Disease

Levine¹,

Levine

Levine³

2013

Cardiology

133

118

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The need for addressing posttraumatic stress disorder (PTSD) among combat veterans returning from Afghanistan and Iraq is a growing public health concern. Current PTSD management addresses psychiatric parameters of this condition. However, PTSD is not simply a psychiatric disorder. Traumatic stress increases the risk for inflammation-related somatic diseases and early mortality. The metabolic syndrome reflects the increased health risk associated with combat stress and PTSD. Obesity, dyslipidemia, hypertension, diabetes mellitus, and cardiovascular disease are prevalent among PTSD patients. However, there has been little appreciation for the need to address these somatic PTSD comorbidities. Medical professionals treating this vulnerable population should screen patients for cardiometabolic risk factors and avail themselves of existing preventive diet, exercise, and pharmacologic modalities that will reduce such risk factors and improve overall long-term health outcomes and quality of life. There is the promise that cardiometabolic preventive therapy complementing psychiatric intervention may, in turn, help improve the posttraumatic stress system dysregulation and favorably impact psychiatric and neurologic function.

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Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder

Cited by 83 publications

References 51 publications

Association between Depression Symptoms with Inflammation and Cardiovascular Risk Factors in Patients Undergoing Peritoneal Dialysis

Association between Depression Symptoms with Inflammation and Cardiovascular Risk Factors in Patients Undergoing Peritoneal Dialysis

Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women

Posttraumatic Stress Disorder and Cardiometabolic Disease

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