Trauma and PTSD May Increase Heart Attack Risk in Women Up to 60%

Patient Expert

New research published in the journal Circulation, the journal of the American Heart Association, suggests that women who experience heightened symptoms of post-traumatic stress disorder (PTSD) are 60 percent more likely to have a heart attack or stroke than women who have never experienced trauma.

The Study:

Study Background:

"Psychological stress is a proposed risk factor for cardiovascular disease (CVD), and posttraumatic stress disorder (PTSD), the sentinel stress-related mental disorder, occurs twice as frequently in women as men. However, whether PTSD contributes to CVD risk in women is not established."1

Study Methods:

  • Researchers drew data from the Nurse's Health Study II (NHS II).*
  • Cardiovascular disease (CVD) events were confirmed by reviewing medical records of other information.
  • Exposure to trauma and PTSD symptoms were assessed using the Brief Trauma Questionnaire and a PTSD screening test.
  • Exposure to trauma and PTSD symptoms in relation to CVD incidents (heart attack and stroke) over a 20-year period in 49,978 participants in the NIS II were evaluated.
  • Data on study participants with trauma exposure was compared to participants with no trauma exposure.

Study Results:

  • Compared to no trauma exposure, demonstrating four or more TPSD symptoms was associated with a 60 percent increased DVD risk after adjusting for age, family history, and family history.
  • Women who experienced trauma, but didn't report PTSD symptoms, had a 45 percent higher risk of heart attack and stroke than women who did not experience trauma.
  • Women with one to three PTSD symptoms did not demonstrate significantly increased CVD event risk.
  • Lifestyle factors appeared to significantly impact the increased risk. Women who had experienced a traumatic event and had either no or four or more PTSD symptoms were more likely to engage in unhealthy behaviors such as smoking and sedentary lifestyles.

Study Conclusions:

"Trauma exposure and elevated PTSD symptoms may increase risk of CVD in this population of women. These findings suggest screening for CVD risk and reducing health risk behaviors in trauma-exposed women may be promising avenues for prevention and intervention."1

Comments from the Researchers:

Jennifer A. Sumner, lead author of the study, stated:

"This study raises awareness that the effects of PTSD don't just stop in the head and that they have more holistic consequences for health/ Our hope is that providers and patients (with PTSD) can be aware of this link and monitor cardiovascular health and try to engage in prevention efforts."3

"Posttraumatic stress is truly heartbreaking. Our findings suggest that psychological impact of trauma is not limited to a woman's
emotional health but also affects her heart health. PTSD emerged as a risk factor for cardiovascular disease in a sample of younger and middle-aged women all under the age of 65. This suggests that cardiovascular health and related risk factors should be assessed early in clinical settings."2

What This Means for Women:

First of all, this research is not reason for panic. It is, however, reason for open, honest, and constructive conversations with our doctors and perhaps reason to seek additional treatment:

  • We should all talk with our doctors about reducing our modifiable risk factors such as smoking, being too sedentary, and sleep issues.
  • If we've experienced trauma in our lives, PTSD screening is in order.
  • If we have PTSD or other issues from trauma, treatment with a qualified mental health professional can help us reduce the impact of these mental health issues on our physical health.

Our bodies are essentially our personal ecosystems. Every physical or mental health issue that we have has the potential to impact everything else. Viewing our health holistically, addressing every part of our health, can greatly improve our health and save us problems down the road.

More Helpful Information:

*About the Nurse's Health Study II:

"The NHS II includes 116,430 U.S. female nurses, aged 25-42 years at enrollment in 1989 and followed biennially. In 2008, when participants were aged 44-62 years, 60,804 women who completed the 2001 Violence questionnaire and 2007 biennial questionnaire were mailed a supplemental questionnaire assessing trauma exposure and PTSD symptoms. To maximize retention, supplemental surveys are only sent to those who return biennial questionnaires. After repeated mailings, 54,282 women returned the questionnaire (89% response rate). This study was approved by the Institutional Review Board of Brigham and Women’s Hospital. Return of the questionnaire via U.S. mail constituted implied consent."1


1 Sumner, Jennifer A., PhD; Kubzansky, Laura D., PhD; Elkind, Mitchell S.V., MD; Roberts, Andrea L., PhD; Agnew0Blais, Jessica, PhD; Chen, Quixan, PhD; Cerdẚ, Magdalena, DrPH; Rexrode, Kathryn M., MD; Rich-Edwards, Janet W., ScD; Spiegelman, Donna, ScD; Suglia, Shakira, ScD; Rimm, Eric B., ScD; Koenen, Karestan C., PhD. "Trauma Exposure and Posttraumatic Stress Disorder Symptoms Predict Onset of Cardiovascular Events in Women." Circulation. published online June 29, 2015.

2 Marcareli, Rebekah. "PTSD Could Raise Risk of Heart Attack and Stroke In Women By 60 Percent." June 30, 2015.

3 Storrs, Carina. "PTSD may increase heart attack, stroke risk in women." June 30, 2015.

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