PTSD may increase stroke risk in middle age

In a new study, researchers found that young adults who suffer from posttraumatic stress disorder (PTSD) may be more likely to experience a transient ischemic attack (TIA) or major stroke event by middle age.

While PTSD has previously been shown to increase the risk of heart disease and stroke in older adults, this is the first study to demonstrate a link between trauma-induced stress disorders and the risk of stroke in young and middle-aged adults.

The research was conducted by a team at the University of North Carolina School of Medicine.

Stroke has a devastating impact on young patients and their families, many of whom struggle to cope with long-term disability, depression and economic loss during their most productive years.

Ten to 14% of ischemic strokes occur in adults ages 18 to 45, and scientists don’t really have a good understanding of the risk factors for stroke in this age group.

Although this study was conducted solely in veterans, PTSD is a debilitating mental condition that affects nearly 8 million adults in the U.S. and about 30 percent of veterans.

People who observe or directly experience a traumatic event such as sexual assault, gun violence/mass shooting, military combat or a natural disaster may develop long-lasting symptoms of anxiety, avoidance, hypervigilance, anger/irritability, flashbacks and nightmares.

In the study, the team analyzed medical data from more than one million young and middle-aged veterans served in recent conflicts in Iraq and Afghanistan. None had previously experienced a TIA or stroke.

During 13 years of follow-up, 766 veterans had a TIA, and 1,877 had an ischemic stroke.

The researchers also found 29% were diagnosed with PTSD, and veterans with PTSD were twice as likely to have a TIA, raising the risk more than established risk factors such as diabetes and sleep apnea.

Veterans with PTSD were 62% more likely to have a stroke, raising the risk more than lifestyle factors such as obesity and smoking.

Veterans with PTSD were more likely to engage in unhealthy behaviors, such as smoking and getting a little exercise, which raises the risk for stroke.

Even after adjusting for other factors, veterans with PTSD were still 61% more likely to have a TIA and 36% more likely to have a stroke than veterans without PTSD.

There was a stronger link between PTSD and stroke in men than in women.

The team says doctors should be aware that mental health conditions such as PTSD are increasingly prevalent among young people and may have major implications for their risk of stroke.

Future work needs to see whether early recognition and successful treatment of PTSD can prevent or decrease the likelihood of developing stroke in those exposed to violence, trauma and severe adversity.

The lead author of the study is Lindsey Rosman, Ph.D., an assistant professor of medicine in the division of cardiology.

The study is published in Stroke.

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