The Association of Posttraumatic Stress Disorder With Clinic and Ambulatory Blood Pressure in Healthy Adults

Edmondson, Donald; Sumner, Jennifer A.; Kronish, Ian M.; Burg, Matthew M.; Oyesiku, Linda; Schwartz, Joseph E.

doi:10.1097/psy.0000000000000523

Cited by 25 publications

(11 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, greater PTSD symptoms were associated with lower SBP and higher DBP levels in trans-ethnic meta-analyses of all cohorts. In particular, the SBP finding was contrary to our hypotheses given the literature documenting associations between PTSD and elevated blood pressure levels and hypertension ( Schnurr et al, 2000 ; Kibler et al, 2009 ; Sumner et al, 2016 ; Burg et al, 2017 ; Edmondson et al, 2018 ; Howard et al, 2018 ). However, when excluding the results of UKBB in trans-ethnic and European ancestry meta-analyses, there was a nominally significant association of greater PTSD symptoms with higher SBP levels, and no significant association was observed for DBP.…”

Section: Discussioncontrasting

confidence: 99%

“…Meta-analytic evidence suggests that individuals with (versus without) PTSD have significantly greater resting systolic blood pressure (SBP) and diastolic blood pressure (DBP), as well as greater DBP response to trauma-related cues ( Buckley and Kaloupek, 2001 ; Pole, 2007 ). In addition, PTSD has been associated with elevated blood pressure and hypertension in a variety of trauma-exposed populations, including military veteran and community-based samples ( Schnurr et al, 2000 ; Kibler et al, 2009 ; Sumner et al, 2016 ; Burg et al, 2017 ; Edmondson et al, 2018 ; Howard et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Examining Individual and Synergistic Contributions of PTSD and Genetics to Blood Pressure: A Trans-Ethnic Meta-Analysis

et al. 2021

Self Cite

View full text Add to dashboard Cite

Growing research suggests that posttraumatic stress disorder (PTSD) may be a risk factor for poor cardiovascular health, and yet our understanding of who might be at greatest risk of adverse cardiovascular outcomes after trauma is limited. In this study, we conducted the first examination of the individual and synergistic contributions of PTSD symptoms and blood pressure genetics to continuous blood pressure levels. We harnessed the power of the Psychiatric Genomics Consortium-PTSD Physical Health Working Group and investigated these associations across 11 studies of 72,224 trauma-exposed individuals of European (n = 70,870) and African (n = 1,354) ancestry. Genetic contributions to blood pressure were modeled via polygenic scores (PGS) for systolic blood pressure (SBP) and diastolic blood pressure (DBP) that were derived from a prior trans-ethnic blood pressure genome-wide association study (GWAS). Results of trans-ethnic meta-analyses revealed significant main effects of the PGS on blood pressure levels [SBP: β = 2.83, standard error (SE) = 0.06, p < 1E-20; DBP: β = 1.32, SE = 0.04, p < 1E-20]. Significant main effects of PTSD symptoms were also detected for SBP and DBP in trans-ethnic meta-analyses, though there was significant heterogeneity in these results. When including data from the largest contributing study – United Kingdom Biobank – PTSD symptoms were negatively associated with SBP levels (β = −1.46, SE = 0.44, p = 9.8E-4) and positively associated with DBP levels (β = 0.70, SE = 0.26, p = 8.1E-3). However, when excluding the United Kingdom Biobank cohort in trans-ethnic meta-analyses, there was a nominally significant positive association between PTSD symptoms and SBP levels (β = 2.81, SE = 1.13, p = 0.01); no significant association was observed for DBP (β = 0.43, SE = 0.78, p = 0.58). Blood pressure PGS did not significantly moderate the associations between PTSD symptoms and blood pressure levels in meta-analyses. Additional research is needed to better understand the extent to which PTSD is associated with high blood pressure and how genetic as well as contextual factors may play a role in influencing cardiovascular risk.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Examining Individual and Synergistic Contributions of PTSD and Genetics to Blood Pressure: A Trans-Ethnic Meta-Analysis

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…More recent studies have embedded physiological monitoring in the ambulatory setting, measuring heart rate, blood pressure, cortisol and α‐amylase in real life. Initial results indicated increased cardiovascular stress reactivity in post‐traumatic stress disorder, blunted cortisol responsivity in depression and psychosis, and increased cortisol reactivity in people at familial risk for psychosis. In this evolving field, technological developments allow for novel passive monitoring approaches for continuous measurement of physiology, which can provide unique insight into the role of stress in the aetiology of mental disorders.…”

Section: Applications Of Esm In the Mental Health Research Fieldmentioning

confidence: 99%

Experience sampling methodology in mental health research: new insights and technical developments

et al. 2018

View full text Add to dashboard Cite

In the mental health field, there is a growing awareness that the study of psychiatric symptoms in the context of everyday life, using experience sampling methodology (ESM), may provide a powerful and necessary addition to more conventional research approaches. ESM, a structured self-report diary technique, allows the investigation of experiences within, and in interaction with, the real-world context. This paper provides an overview of how zooming in on the micro-level of experience and behaviour using ESM adds new insights and additional perspectives to standard approaches. More specifically, it discusses how ESM: a) contributes to a deeper understanding of psychopathological phenomena, b) allows to capture variability over time, c) aids in identifying internal and situational determinants of variability in symptomatology, and d) enables a thorough investigation of the interaction between the person and his/her environment and of real-life social interactions. Next to improving assessment of psychopathology and its underlying mechanisms, ESM contributes to advancing and changing clinical practice by allowing a more fine-grained evaluation of treatment effects as well as by providing the opportunity for extending treatment beyond the clinical setting into real life with the development of ecological momentary interventions. Furthermore, this paper provides an overview of the technical details of setting up an ESM study in terms of design, questionnaire development and statistical approaches. Overall, although a number of considerations and challenges remain, ESM offers one of the best opportunities for personalized medicine in psychiatry, from both a research and a clinical perspective.

show abstract

“…Several limitations need to be considered when interpreting our findings. As in some previous research (Edmondson et al, 2018), PTSD symptoms were not anchored to a specified traumatic event. We ran a sensitivity analysis to examine past-year exposure to events consistent with a Criterion A trauma and total PTSD symptom count.…”

Section: Limitationsmentioning

confidence: 95%

Elucidating posttraumatic stress symptom dimensions and health correlates among postpartum women

Thomas

Cleveland

Pietrzak

et al. 2021

Journal of Affective Disorders

Self Cite

View full text Add to dashboard Cite

Background: Posttraumatic stress disorder (PTSD) is associated with interpersonal dysfunction and adverse maternal health during the perinatal period (extending from conception through one year postpartum). However, PTSD is a heterogeneous disorder, and little is known about which aspects of this disorder may be particularly deleterious to the health of new mothers. Such data may inform more personalized approaches to PTSD prevention and treatment among postpartum women. Methods: Using confirmatory factor analysis, we compared three models of PTSD symptom structure-the fourfactor dysphoria model, four-factor emotional numbing model, and five-factor dysphoric arousal model-in 1,663 postpartum women from the Community and Child Health Network (CCHN). We examined associations between PTSD symptom dimensions of the best-fitting model with four correlates relevant to maternal health and functioning-parenting stress, partner relationship stress, relationship satisfaction, and contraceptive use.Results: Though all models fit well, the five-factor dysphoric arousal model provided optimal fit. Symptom dimensions from this model-re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal-evidenced differential associations with the maternal health indicators. Numbing symptoms were most strongly associated with indicators of poor interpersonal functioning, whereas dysphoric arousal symptoms were most strongly related to low-efficacy contraceptive use. Limitations: Our cross-sectional study assessed DSM-IV PTSD symptoms. Conclusions: PTSD symptoms among postpartum women are best-represented by five factors. Numbing symptoms (e.g., restricted affect, detachment) are most strongly associated with interpersonal difficulties, whereas dysphoric arousal symptoms (e.g., agitation, irritability) are linked with low-efficacy contraceptive use. Screening for these symptoms may help promote the health of new mothers.

show abstract

The Association of Posttraumatic Stress Disorder With Clinic and Ambulatory Blood Pressure in Healthy Adults

Abstract: PTSD is associated with greater systolic BP, partly because of greater anxiety, and systolic BP reactivity to anxiety throughout the day. Daily anxiety and related BP reactivity may be targets for interventions to reduce the cardiovascular risk associated with PTSD.

Cited by 25 publications

References 37 publications

Examining Individual and Synergistic Contributions of PTSD and Genetics to Blood Pressure: A Trans-Ethnic Meta-Analysis

Examining Individual and Synergistic Contributions of PTSD and Genetics to Blood Pressure: A Trans-Ethnic Meta-Analysis

Experience sampling methodology in mental health research: new insights and technical developments

Elucidating posttraumatic stress symptom dimensions and health correlates among postpartum women

Contact Info

Product

Resources

About