Stiffness of large arteries and cardiovascular risk in patients with post-traumatic stress disorder.
OBJECTIVE
Post-traumatic stress disorder (PTSD) develops after exposure to particularly traumatic events. Its severity depends on the nature and intensity of the stressor and susceptibility of the exposed person. The present study was carried out to find out whether PTSD and its severity, resulting from deportation to Siberia in the patients' childhood (from 1940 to 1946), have any association on the somatic health status and cardiovascular risk of these persons in advanced age.


RESULTS
Eighty patients with PTSD and 70 subjects without PTSD followed up in primary care setting were enrolled in the study. Post-traumatic stress disorder was diagnosed according to the DSM-IV criteria; severity of the symptoms included in the criteria was also assessed. All patients were subject to a standardized interview including demographic data and current and past diseases, supplemented with physical examination, biochemical tests, and aortic pulse wave velocity (PWV). The group of patients with PTSD resulting from deportation to Siberia in their childhood had higher prevalence of coronary artery disease (71.3 vs. 44.3%, P < 0.001), diabetes (26.3 vs. 11.4%, P < 0.05), and hearing impairment (23.8 vs. 2.9%, P < 0.001) than controls. They also had higher incidence of blood pressure >140/90 (86.0 vs. 65.7%, P = 0.003), fasting blood glucose >5.6 mmol/L (65.0 vs. 45.7%, P = 0.018), HDL level <1.0 mmol/L (31.3 vs. 8.6%, P = 0.0006), and triglyceride level >2.3 mmol/L (62.5 vs. 321.4%, P = 0.001). Patients with PTSD had higher PWV (13.7 vs. 12.9 m/s, P= 0.042). The magnitude of PWV increased with the severity of PTSD (P = 0.001). Stepwise logistic regression has shown that PTSD was a strong factor promoting the appearance of coronary heart disease in the former deportees group (OR 3.80; 95% CI: 1.62-8.94; P = 0.002).


CONCLUSIONS
Several-year long deportation in childhood and PTSD elevated overall cardiovascular risk in the group of former deportees compared with the group of persons without history of such a traumatic experience.
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Śniadeckich 10, 31-351 Cracow, Poland. jwalczewska@su.krakow.pl
Jolanta
J
Walczewska
Krzysztof
K
Rutkowski
Barbara
B
Wizner
Marcin
M
Cwynar
Tomasz
T
Grodzicki
D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001783:Blood Flow Velocity; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000523:psychology*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D050356:Lipid Metabolism; D008297:Male; D011044:Poland / Q000208:ethnology; D012036:Refugees; D012307:Risk Factors; D012800:Siberia; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000503:physiopathology; D059289:Vascular Stiffness / Q000502:physiology*
D015415:Biomarkers; D001786:Blood Glucose