Posttraumatic Stress Disorder and Cardiometabolic Disease

Abstract

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.

Mitochondrial DNA copy number is reduced in male combat veterans with PTSD

“…metabolic dysregulation, increased BMI, visceral adiposity, diabetes, insulin resistance (Levine et al 2014)) are themselves associated with lowered mtDNAcn (Choi et al 2001, Kim J. H. et al 2012, Lee H. K. et al 1998, Lee J. Y. et al 2014). However, we did not observe significant correlations between BMI and mtDNAcn in our samples.…”

“…In addition to the traditional psychiatric symptoms, individuals with PTSD have a substantially higher medical burden, with increased rates of cardiometabolic disturbances and early mortality, suggesting widespread physical and biological concomitants of the disease (Levine et al 2014). …”

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

“…The health consequences of PTSD are substantial, affecting multiple organ systems, with evidence linking PTSD to diseases such as cancer, arthritis, digestive disease, and cardiovascular disease (CVD) (13,14,112). The evidence demonstrating increased risk for CVD in PTSD (9,15,19,49,57,58) is compelling, and several excellent recent review articles have highlighted this association (20,23,52,63,112). While this association could certainly be due, in part, to related unhealthy behaviors, such as increased prevalence of smoking, poor diet, and physical inactivity (46,119).…”

Exercise and Diet as Potential Moderators Between Trauma, Posttraumatic Stress, Depression, and Relationship Quality Among Emerging Adults

“…There is already research supporting the benefits of exercise for reducing symptoms of depression (e.g., Josefsson, Lindwall, & Archer, 2014) and anxiety (e.g., Jayakody, Gunadas, & Hosker, 2014), which commonly co-occur with PTSD. Regular physical exercise may improve symptoms of PTSD (Levine, Levine, & Levine, 2013) and preliminary research supports the further investigation of aerobic exercise as a treatment for PTSD among women survivors of interpersonal violence (Smith, Rotunda, & Cosio-Lima, in press). There is also preliminary support for dietary practices, such as omega-3 fatty acid supplementation, for the secondary prevention of posttraumatic stress (Matsumura, Noguchi, Nishi, & Matsuoka, 2012;Matsuoka et al, 2010).…”