Post-traumatic stress disorder may increase the risk of cardiovascular disease | The latest news for doctors, nurses and pharmacists

Post-traumatic stress disorder (PTSD) appears to share genetic risks with Cardiovascular diseases (CVD), suggesting that post-traumatic stress disorder is a contributing factor to the development of coronary artery disease (CAD).
Hypertensionreveal a study.

“Individuals with PTSD are at increased risk of developing cardiovascular disease (such as myocardial infarction and stroke),” the researchers said. “The evidence for this association is so compelling that the National Institutes of Health set up a task force to identify gaps in the literature, including the need for large-scale genomic studies to identify shared genetic risks.”

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

Summary statistical datasets were processed using the following criteria: SNP h2 > 0.05, calculate the z-statistics (z = beta/SE or z = log(OR)/SE), and filter out unchanged SNPs (0

PTSD has shown significant genetic associations with CVD (pJ= 0.24, SE = 0.06). Mendelian randomization analyzes revealed a possible causal relationship of PTSD to hypertension (β = 0.20, SE = 0.04), but not the opposite. [Am J Psychiatry 2022;179:814-823]

Summary PTSD statistics were a strong predictor of PTSD diagnostic status (R2= 0.27), which was significantly improved by including summary statistics from cardiovascular disease and major depressive disorder (MDD; R).2= 1.30). Pathway enrichment analyzes also revealed the contribution of genetic variants to common PTSD-CVD risk, such as those involved in postsynaptic structure, synapse organization, and signaling pathways mediated by interleukin-7.

“Our findings indicate that there is significant genetic overlap between PTSD and cardiovascular disease, PTSD and MDD may be risk factors leading to hypertension and coronary heart disease, and genetic prediction of PTSD risk has been improved from By looking at polygenic risks for cardiovascular disease and psychiatric disorders, the researchers said.

mechanisms

One possible driver of the association between PTSD/MDD and CVD is elevated sympathetic arousal that leads to elevated blood pressure, both directly (ie, chronic stress-induced hypertension) and via the renin-angiotensin system (ie, stress-induced hypertension). ) to secrete renin and angiotensin II which cause vasoconstriction).

“Our results provide support for this mechanism, but we cannot rule out the possibility that confounding factors or mediating effects (such as diet and smoking) may be responsible for these associations, which should be examined in future research,” the researchers said.

“Future studies of genetic risk and prognostic prediction would benefit from incorporating a 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 cardiovascular disease risk. Identification of individuals with PTSD and shared CVD risks, for example, will help clinicians choose interventions that can improve some features of cardiovascular function, according to the researchers.

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

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

They added: “The next step in this type of work is to determine whether existing cognitive, behavioral, and pharmacological therapies actually reduce CVD risk in PTSD, and to determine whether they are more effective for individuals with a high genetic risk for both disorder.” Post-traumatic stress disorder and cardiovascular disease.” .

Leave a Comment