Tuesday, January 02, 2007

Post Traumatic Stress Linked to Heart Disease

A study of combat veterans living in Greater Boston, Massachusetts has found a link between post traumatic stress severity and increased risk of coronary heart disease in older men.

The study is published in the Archives of General Psychiatry and was conducted by scientists from the Harvard School of Public Health with the collaboration of colleagues from Boston and Harvard.

The researchers looked at a total of 1,996 records of men in the Veterans Affairs Normative Aging Study. The men had completed one of two well-known questionnaires for assessing Post Traumatic Test Disorder (PTSD); one group (944 men) in 1986 and the other (1,002 men) in 1990.

They correlated the results against the incidence of coronary heart disease (CHD, fatal and non-fatal heart attack or stroke, and angina) in the two groups up to May 2001.

The two PTSD questionnaires were the Mississippi Scale for Combat-Related PTSD (35 questions) and the Keane PTSD scale (46 questions).

Overall, the two groups showed low to moderate symptoms of PTSD, but there was a significant association between symptom severity and later onset of CHD - the more severe the symptoms, the greater the risk of CHD later in life.

For every significant step up in symptoms (one standard deviation in the statistical spread of the data) there was a significant increase in CHD risk: 21 per cent if you include angina, 26 per cent if you don't. Also, the results were the same when depressive symptoms were taken into account.

The researchers believe this to be the first study to show a link between PTSD severity and later onset of CHD, regardless of whether the participants are depressed or not.

When we have PTS our body overreacts to things that other people just shrug off or find mildly irritating. For instance a sudden loud noise can provoke an exaggerated startle response with increased heart rate, sweaty palms, shortness of breath and feelings of panic and helplessness.

A person with PTS discharges more adrenalin in the course of a day than a "normal" person. It is thought this increases the wear and tear on the cardiovascular system.

Questionnaire-based tests of PTS assess symptoms such as nightmares, flashbacks, headaches and feelings of panic.

An emerging area of PTS is what is becoming known as STSD - or secondary traumatic stress disorder. Some of the helping professionals who provided support for the victims of 9/11, for example, have been diagnosed with this. They were not involved in the tragedy directly, but by being "vicariously" involved, listening to the stories of the victims and empathising with their feelings, they have developed a sort of PTS with some of the same symptoms - nightmares, intrusive thoughts, feelings of helplessness and hopelessness.

PTS affects us on a deeply psychological level too - it shakes our innermost beliefs and our sense of self. What we previously thought was a mostly safe world with a few bad things in it suddenly becomes a mostly bad world with very little good in it.

The spiritual impoverishment that comes from such a reversal causes a complete shift in personality. Lively, warm-hearted, charming people become frightened, depressed and moody through PTSD. Our natural inclination is to keep away, to shun and avoid them. But perhaps what they need most is for us to hang in there, not in a gushing do-gooder sense, but with a light touch, a smile and more than the usual degree of acceptance and tolerance.

Written by: Catharine Paddock
Writer: Medical News Today

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