Women with post-traumatic stress disorder have up to a 60% higher chance of a heart attack or stroke, according to a study of almost 50,000 participants.

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Mental trauma may produce physical problems.

In the first study to examine trauma exposure, post-traumatic stress disorder (PTSD) and onset of cardiovascular disease exclusively in women, those with no PTSD symptoms but who reported traumatic events had 45% higher rates of cardiovascular disease.

The results are published in the American Heart Association’s journal Circulation.

Jennifer Sumner, PhD, lead author and epidemiologist at Columbia University’s Mailman School of Public Health in New York City, says:

“PTSD is generally considered a psychological problem, but the take-home message from our findings is that it also has a profound impact on physical health, especially cardiovascular risk.”

Dr. Sumner, also a visiting scientist at the Harvard T.H. Chan School of Public Health in Boston, MA, adds:

“This is not exclusively a mental problem – it’s a potentially deadly problem of the body as well.”

The researchers examined 49,978 women in the Nurses’ Health Study II, an ongoing cohort study of younger and middle-aged women that started in 1989.

The study investigated exposure to trauma and PTSD symptoms in relation to incident cardiovascular disease over the 20-year study period.

Researchers used a questionnaire to evaluate different types of traumatic experiences and PTSD symptoms. The main findings of the study were that:

  • Women with four or more PTSD symptoms had 60% higher rates of cardiovascular disease compared with women who no history of being exposed to traumatic events
  • Rates of cardiovascular disease were 45% higher among women with no PTSD symptoms, but who reported traumatic events
  • Unhealthy behaviors like smoking, obesity, lack of exercise and medical factors such as high blood pressure accounted for almost half of the association between elevated PTSD symptoms and cardiovascular disease.

PTSD tends to be associated with male military service. But the researchers point out that PTSD is twice as common in women as in men.

Most studies of cardiovascular disease risk in PTSD patients have been conducted in men who have served in the military, or among disaster survivors.

PTSD affects some women after traumatic events such as a natural disaster, unwanted sexual contact or physical assault. They may suffer mental flashbacks of the trauma, insomnia, fatigue, difficulty with memory or concentration, and numbed emotions. Other symptoms include nightmares, irritability or being startled easily.

Karestan Koenen, the study’s senior author and professor of epidemiology at Columbia University Mailman School of Public Health and Harvard T. H. Chan School of Public Health, says:

The medical system needs to stop treating the mind and the body as if they are separate. Patients need access to integrated mental and physical health care.”

Dr. Sumner agrees – women need to get mental health care to treat symptoms as well as be monitored for signs of cardiovascular problems. More than half of the people in the US who suffer from PTSD do not get treatment, especially minorities.

Heart disease has also been linked to panic disorder in a recent study. The study published in June found that panic attacks were linked to heart disease, although there could be overlap to confuse the issue.