Stress Disorders Associated with an Increased Risk of Heart Disease

A Swedish study suggests that people with disorders such as post-traumatic stress disorder (PTSD) are more likely to develop cardiovascular disease, and that the risk may be greater in the months following the diagnosis.

For this study, the researchers looked at data from 136,637 individuals diagnosed with PTSD, an acute stress response, an adjustment disorder, or other mental health problems caused by mental health problems. stressful or traumatic events. They also examined data on 171,314 siblings from these patients who were not exposed to stressful or traumatic events, as well as nearly 1.4 million others not exposed to this exposure.

None of the subjects had cardiovascular disease at the beginning of the study period.

For 27 years of follow-up, the researchers calculated what proportion of people in each group developed cardiovascular disease each year. Among those suffering from stress, atherosclerosis, arrhythmias, embolisms, high blood pressure, stroke, heart attacks and other cardiovascular diseases are diagnosed on average every year in 10.5 out of 1000 people. compared to an average of 8.4 per 1,000 of siblings and 6.9 per 1,000 in the larger population without stress disorder.

"The vast majority of human beings are at some point in their lives exposed to trauma or stressful events, and a significant proportion of them develop serious psychiatric reactions such as post-traumatic stress disorder or a Disorder of adaptation, "said Huan Song, senior author of the study at the Icelandic University in Reykjavik and the Karolinska Institutet in Stockholm.

"Medical providers need to be aware that these vulnerable populations may be at increased risk for a variety of cardiovascular diseases, which necessitates increased clinical awareness / surveillance and, possibly, early intervention in patients with HIV / AIDS-related disorders. newly diagnosed stress, "said Song by email. .

The researchers reported in The BMJ the risk of serious and acute cardiovascular events, such as cardiac arrest and heart attack, was particularly high during the first six months following the diagnosis of a disorder. of stress and during the first year for other types of cardiovascular disease.

And there was a stronger connection between stress disorders and cases of cardiovascular disease that appeared earlier in life, before the age of 50, than for the cases diagnosed later, revealed the most common condition. study.

The study was not designed to prove whether or how stress disorders could directly cause cardiovascular disease.

Although researchers have taken into account several factors that may contribute to cardiovascular diseases such as family history, medical history and underlying psychiatric disorders, it is still possible that some unmeasured stress-coping behaviors, such as: Smoking and drinking also influenced the results, the authors note.

It is also unclear to what extent the treatment of stress disorders or underlying psychiatric problems could affect the chances of developing cardiovascular problems.

"The evidence we have so far does not show that treating psychological problems leads to a reduction in heart disease," said author of an accompanying editorial, Simon Bacon, of Concordia University in Montreal.

"However, very few studies have been conducted and there are some problems. So it's always possible that the right kind of treatment actually reduces the PTSD and the risks of developing heart disease, "Bacon said via e-mail.

However, patients should always consult a doctor if they feel that stress is affecting their physical or mental health, Bacon said.

"There are very good treatments for this type of disorder and no one should suffer unnecessarily," said Bacon. "It is also possible that in dealing with these disorders, the person improves not only his mental health, but also his physical health."