Posttraumatic stress disorder and nocturnal blood pressure dipping in young adult African Americans.
OBJECTIVE
To evaluate the relationship between posttraumatic stress disorder (PTSD) and nocturnal blood pressure (BP) dipping in young adult African Americans (AAs). PTSD is associated with physical illnesses including cardiovascular conditions. Sleep disturbances related to heightened arousal likely contribute to physical health risk; however, this possibility has not been studied. The studies that have found a relationship between PTSD and hypertension (HTN) have substantial representation of AAs. AAs have elevated rates of HTN and are more likely to exhibit an absence of the normal "dip" of BP at night. Nocturnal BP "nondipping" is an established risk factor for HTN and its cardiovascular complications. Nocturnal BP nondipping and sleep disturbances of PTSD have both been linked to sympathetic nervous system function.


METHODS
Thirty healthy young adult AAs (60% female; mean age = 20.0 years; 17 with lifetime full or subthreshold PTSD, 4 with current symptoms) received 24-hour BP and actigraphy monitoring, filled out sleep diaries, and had structured clinical assessment of PTSD.


RESULTS
There were significant associations of lifetime full and subthreshold PTSD and BP nondipping, and the degree of nocturnal dipping correlated with lifetime and current PTSD severity.


CONCLUSIONS
Elevated nocturnal BP may be a link between PTSD and cardiovascular morbidity in AAs that can be targeted in prevention.
Mellman
Thomas A
TA
Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, Washington, DC 20059, USA. TMellman@Howard.edu
Brown
Denver D
DD
Jenifer
Ericka S
ES
Hipolito
Maria M S
MM
Randall
Otelio S
OS
D000293:Adolescent; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002940:Circadian Rhythm / Q000502:physiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D012890:Sleep / Q000502:physiology*; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology; D013564:Sympathetic Nervous System / Q000502:physiology; D055815:Young Adult