Women who have experienced traumatic events and those with post-traumatic stress disorder (PTSD) are at a greater risk of heart attack and stroke, new research suggests.
PTSD, a condition characterized by flashbacks of trauma, insomnia, fatigue, trouble remembering or concentrating, and emotional numbing, affects about 8 million Americans in any given year, according to the U.S. Department of Veterans Affairs. Women are twice as likely as men to develop PTSD.
In the study, published in the American Heart Association journal Circulation, researchers at Columbia University's Mailman School of Public Health and the Harvard T.H. Chan School of Public Health examined about 50,000 patients over the span of 20 years. They monitored rates of heart disease and used a questionnaire to evaluate traumatic events and PTSD symptoms.
The results found that women with four or more symptoms of PTSD had a 60 percent higher risk of developing cardiovascular disease than women who hadn't experienced traumatic events. Furthermore, women with no PTSD symptoms but who reported traumatic events had a 45 percent higher risk of heart disease.
While PTSD is most commonly associated with war veterans, CBS News contributor Dr. Tara Narula, a cardiologist at Lenox Hill Hospital in New York, told "CBS This Morning" that's not always the case.
"It comes with any sort of exposure to death or injury or sexual assault," she said. "So things like a motor vehicle accident, a natural disaster, a life-threatening illness, hospitalization in the intensive care unit, sexual assault, or physical injury -- all of those can lead to PTSD."
Narula pointed out that although other risk factors, including obesity, lack of exercise, diabetes, cigarette smoking, and high blood pressure can contribute to the onset of heart disease, the link to PTSD still remained despite those factors. "In fact, those unhealthy lifestyles accounted for less than 50 percent of the increase that we saw," she said.
Experts say the study highlights the importance of the connection between the mind and the heart.
"In PTSD unfortunately what happens is that you have flashbacks," Narula said. "You're reliving the event over and over again. It's like you can't forget it."
That results in a hyper-aroused state, she explained, so feelings of danger are always present. "What that does is you're turning the stress response on in your body over and over again for months, weeks, or years," she said. "So you're increasing your heart rate, increasing your blood pressure, causing disregulation of the stress response system and the stress hormones, and you're increasing inflammatory markers. All of that can cause constriction of blood vessels and clots to form in blood vessels."
For the study authors, the research suggests PTSD needs to be recognized for its effects beyond mental health.
"PTSD is generally considered a psychological problem, but the take-home message from our findings is that it also has a profound impact on physical health, especially cardiovascular risk," the study's lead author Jennifer Sumner, an epidemiologist at Columbia University's Mailman School of Public Health, said in a statement. "This is not exclusively a mental problem -- it's a potentially deadly problem of the body as well."