Review article

CARDIOVASCULAR DISEASE RISK FACTORS IN PATIENTS WITH POSTTRAUMATIC STRESS DISORDER (PTSD): A NARRATIVE REVIEW

Marina Šagud ; School of Medicine, University of Zagreb, Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
Nenad Jakšić orcid.org/0000-0002-5286-720X ; National Center for Psychotrauma, Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
Bjanka Vuksan-Ćusa ; School of Medicine, University of Zagreb, Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, University of Osijek, Osijek, Croatia
Mladen Lončar ; School of Medicine, University of Zagreb, Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
Ivana Lončar ; National Center for Psychotrauma, Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
Alma Mihaljević Peleš ; School of Medicine, University of Zagreb, Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
Davor Miličić ; School of Medicine, University of Zagreb, Department for Cardiovascular Diseases, University Hospital Centre Zagreb, Zagreb, Croatia
Miro Jakovljević ; School of Medicine, University of Zagreb, Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia

Abstract

Posttraumatic stress disorder (PTSD) is a chronic condition related to severe stress and trauma. There is a mounting evidence about increased prevalence and mortality from cardiovascular diseases (CVD) in patients with PTSD. This review summarizes the current data on possible relations between PTSD and increased risks of CVD, including biological, psychological and behavioral factors. Biological factors refer to increased prevalence of metabolic syndrome (MetS), hypertension, elevation of pro-inflammatory cytokines and homocysteine levels. Peripheral Brain-derived neurotropic factor (BDNF), serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and quantitative electroencephalogram (qEEG) are promising surrogate markers of increased cardiovascular risk. Among psychological factors, some personality traits, such as neuroticism and trait impulsivity/hostility, contribute to the development of PTSD, and are associated with general cardiovascular distress. Recently, type-D (distressed) personality is usually investigated in relation to cardiovascular morbidity, but in populations other than PTSD patients. Behavioral factors refer to
unhealthy life-styles, encompassing high smoking rate, drug substances abuse and addiction, physical inactivity and unhealthy diet.
The relationships among all these factors are complex and yet incompletely taken into consideration. Because of a high prevalence of
CVD in patients with PTSD, there is a strong need for a more intensive focus on this vulnerable population in both primary and secondary cardiovascular prevention as well as in effective treatment possibilities.

Keywords

PTSD; cardiovascular disease (CVD); CVD risk factors; personality; type-D personality- resilience; resilience; enhancing strategies

Hrčak ID:

190598

URI

https://hrcak.srce.hr/190598

Publication date:

4.12.2017.

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