PTSD can increase the risk of cardiovascular diseases | Latest news for Doctors, Nurses and Pharmacists

Post-traumatic stress disorder (PTSD) appears to share a genetic risk with cardiovascular disease (CVD), indicating that PTSD is a contributing factor in the development of coronary artery disease (CAD) and
hypertensionreveals a study.

“People with PTSD are much more likely to be diagnosed with CVD (eg, myocardial infarction, stroke),” the researchers said. “The evidence for this link is so compelling that the National Institutes of Health convened a task force to determine gaps in the literature, including the need for large-scale genomic studies to identify shared genetic risk.”

The research team used a large healthcare biobank dataset (n = 36,412), combined with genome-wide association study (GWAS) summary statistics from publicly available PTSD and CVD studies. They collected disease phenotypes from electronic records and genotyped de-identified genetic data from the biobank using the Illumina SNP Array.

Summary statistical data sets were processed using the following criteria: SNP heritability htwo >0.05, calculate z-stats (z=beta/SE or z=log(OR)/SE), filter out nonvariable SNPs (0

PTSD showed significant genetic associations with CVD (rGRAM=0.24, SE=0.06). Mendelian randomization analyzes revealed a possible causal link between PTSD and hypertension (β=0.20, SE=0.04), but not vice versa. [Am J Psychiatry 2022;179:814-823]

PTSD summary statistics were a strong predictor of PTSD diagnostic status (Rtwo=0.27), which was markedly improved by including summary statistics for CVD and major depressive disorder (MDD; Rtwo=1.30). Pathway enrichment analyzes also revealed the contribution of genetic variants to shared PTSD-CVD risk, such as those involved in postsynaptic structure, synapse organization, and interleukin-7-mediated signaling pathways.

“Our results indicate that there is substantial genetic overlap between PTSD and CVD, PTSD and MDD may be risk factors leading to the development of hypertension and CAD, and genetic prediction of PTSD risk is improved by considering polygenic risk. of CVD and MDD. the researchers said.

mechanisms

One of the possible drivers of the association between PTSD/MDD and CVD is elevated sympathetic activation leading to hypertension, both directly (ie, chronically elevated blood pressure due to stress) and through the renin-angiotensin system (ie , high blood pressure due to stress). to the release of renin and angiotensin-II that causes vasoconstriction).

“Our findings support this mechanism, but we cannot exclude the possibility that confounding factors or mediating effects (eg, diet, smoking) are responsible for these associations, which should be examined in future research,” the researchers said. .

“Future studies of genetic risk and diagnostic prediction would benefit from incorporating this polygenic risk approach,” they added.

clinical implication

These findings may provide benefits in risk identification, which can be used to improve PTSD treatment and reduce CVD risk. Identifying people with shared risk of PTSD and CVD, for example, will help clinicians choose interventions that may improve certain features of cardiovascular function, according to the researchers.

Previous studies have documented the effects of some psychiatric and cardiovascular disease medications on cardiovascular function, but only a few have tested the effects of these treatments on subsequent cardiovascular disease risk in people with PTSD. [Neuropharmacology 2012;62:617-627;
N Engl J Med 2018;378:507-517]

“Drugs that target the renin-angiotensin system (eg, ACE inhibitors, beta-blockers) have shown efficacy in rodent models, but research in humans with PTSD has been mixed,” the researchers noted. [Biol Psychiatry 2014;75:864-872;
Biol Psychiatry 2021;90:473-481]

“The next step in this line of work is to determine whether existing cognitive-behavioral and pharmacological treatments actually reduce CVD risk in PTSD, and whether they are more effective for people at high genetic risk for both PTSD and CVD.” they added. .

One Comment on “PTSD can increase the risk of cardiovascular diseases | Latest news for Doctors, Nurses and Pharmacists”

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