title: High prevalence of posttraumatic stress in patients with primary hypertension.
abstract: OBJECTIVE
  Posttraumatic stress disorder (PTSD) is associated with a higher rate of arterial hypertension. However, data about prevalence rates of PTSD in patients suffering from arterial hypertension as well as the relation to blood pressure (BP) control are lacking.
  
  
  METHODS
  We recruited 145 patients with primary hypertension from March to November 2012 at the cardiologic outpatient clinic at Ulm University Medical Center. Symptoms of PTSD (assessed with the Posttraumatic Diagnostic Scale), perceived stress (Perceived Stress Scale; Trier Inventory for Chronic Stress), depression and anxiety (Hospital Anxiety and Depression Scale) were assessed by self-report. Office BP was measured and medical data were collected.
  
  
  RESULTS
  Criteria for a full PTSD syndrome were met by 13 patients (9%). Posttraumatic stress was higher in the group of patients with controlled (M=10.9, S.D.=9.8) than in those with uncontrolled hypertension (M=3.9, S.D.=5.4; P<.001). In linear regression, only status of hypertension control (beta=.39, P<.001) predicted posttraumatic stress significantly, even after controlling for important cofactors.
  
  
  CONCLUSIONS
  PTSD is highly prevalent in hypertensive patients, especially in those with controlled hypertension. An explaining mechanism could be the higher use of health care by patients suffering from PTSD. The mental needs of these patients should be focused in addition to the well-established somatic care.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany; Department of Internal Medicine II - Cardiology, Angiology, Pulmonology, Sports and Rehabilitation, University of Ulm Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany. Electronic address: elisabeth.balint@uniklinik-ulm.de.
authors.forename: Elisabeth Maria
authors.initials: EM
authors.lastname: Balint
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Preslava
authors.initials: P
authors.lastname: Boseva
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany; Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081 Ulm, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Schury
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Guendel
authors.affiliation: Department of Internal Medicine II - Cardiology, Angiology, Pulmonology, Sports and Rehabilitation, University of Ulm Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rottbauer
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Waller
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology*; D001794:Blood Pressure; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D013315:Stress, Psychological / Q000453:epidemiology*
chemical_list: D000959:Antihypertensive Agents
keywords: Hypertension control; Posttraumatic stress disorder; Primary hypertension; Trauma