Why are young veterans who suffer from post-traumatic stress disorder (PTSD) being diagnosed with cardiovascular and metabolic disorders at rates much higher than veterans with no identified psychiatric disorders? Could treating PTSD reduce the risk of these poor health outcomes?
A Saint Louis University researcher has received a grant to study the effects of treating post-traumatic stress disorder (PTSD) on cardiovascular and metabolic health. Jeffrey Scherrer, Ph.D., associate professor in Family and Community Medicine, received $2,348,320 from the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH).
Following the wars in Iraq and Afghanistan, veterans with PTSD have an approximate two-fold increase in hypertension, dyslipidemia, diabetes and Ischemic heart disease, Scherrer said. Controlling for depression, anxiety and cardiac risk, women with five or more PTSD symptoms in a 14-year prospective study were more than three times as likely to develop coronary heart disease compared to a non-PTSD control group.
Many veterans with PTSD exhibit the unhealthy lifestyle behaviors, including a lack of physical activity, poor nutrition, smoking, drug use and excessive drinking. Some of these habits may be used to cope with trauma and high levels of stress. Long term, these poor health behaviors may account for the greater risk of cardiovascular and metabolic disease in patients with PTSD.
Scherrer's study will seek to determine if patients who have been successfully treated for PTSD are more likely to adopt a healthier lifestyle.
"If what our pilot data suggests is true and reductions in PTSD symptoms are associated with improved health behaviors then physicians and therapists can work during the start of PTSD treatment to encourage patients to engage in changing their health behavior," Scherrer said. "If symptom reduction isn't related to healthier life choices, it lends support for aggressive health promotion and screening of patients with PTSD treatment."
If the research finds that a diagnosis of PTSD remains a risk factor for cardiovascular and metabolic disease despite improved health behaviors and symptom reduction, then lifelong aggressive monitoring of these patients is warranted, Scherrer said.
The study will use Veterans Health Administration medical record data from patients between the ages of 18 and 70, the majority of whom will have served in the Iraqi and Afghani conflicts.
The study has two components. An independent company will do medical chart abstraction to gain data from Veterans Administration patients being treated for PTSD in clinics that provide cognitive processing therapy or prolonged exposure therapy.
"Medical records lack precision to fully address the question," Scherrer said. "This is why detailed data from PTSD treatment encounters will be abstracted, then merged with the larger number of variables contained in the VA's national patient data."
In the first year of funding, the researchers will collect the medical record data. Analysis will begin in the second year of the study.
Scherrer notes that combat-related activities are not the only reason veterans may suffer from PTSD.
"Trauma for these veterans is not always related to their military service," Scherrer said. "We could be looking at cases of life-threatening experiences like automobile accidents or childhood trauma. The results from our study should be generalized to other traumas and PTSD experienced in the civilian population."
Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) under award number 1 R01 HL125424-01A1.
Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious diseases.