Perceived impact of heart disease exacerbated by people with PTSD

In a study with 1022 men and women with heart disease who exercised with post-traumatic stress disorder, the effects of their disease as more severe and debilitating than those without PTSD, even if their heart health was not real undermined by objective measures.

The results are reported by researchers at the San Francisco VA Medical Center and University of California at San Francisco in November 2009 Issue of Archives of General Psychiatry.

Researchers at Beth E. Cohen, MD, MAS, medical director of lead SFVAMC seen a number of effects of heart disease as indicated in the study participants, including the frequency and severity of chest pain, limitation of physical activity and daily functioning and overall quality of life.

If the participant is then measured cardiac function by a variety of objective measures: the ability of treadmill exercise, the fraction of left ventricular ejection, which measures the efficiency with which the heart pumps blood, and ischemia inducible, which receives more oxygen in the heart during exercise activities.

The 95 patients with PTSD reported significantly greater perceived burden of symptoms, greater physical limitation and reduced quality of life, than those without PTSD, even if they correspond to objective measures of cardiac function.

The differences in the perception remained even after they excluded participants with depression, should also influence how people perceive the seriousness of heart disease, says Cohen, who is also professor of medicine at UCSF.

"It's something unique and independent of PTSD as heart disease stress, regardless of the actual capture of cardiac function," says Cohen. "Unfortunately, we do not dare speculate on what it is, without having more precise data.

The authors provide a number of studies that PTSD Height 8 to 12 per cent in the general population and nearly 13 percent among 30 sets of military veterans.

Cohen suggests that for patients with heart disease and PTSD, "we must not only improve physical measures such as cholesterol and blood pressure off, but interpret it as the treatment of symptoms of stress syndrome posttraumatic well. In addition to improving the emotional health of patients, our results it can affect the level of functioning and improve quality of life of people. And that's what we really want to know, to -- as the treatment of PTSD may affect heart health. "

Currently, Cohen is the research team working on a follow-up study deals later with the same five years. "We can not determine if the person suffering from PTSD had worsened over time as regards the heart results, she said.

Co-authors of the study were Charles R. Marmar, MD, and Thomas Neylan, MD, of UCSF and SFVAMC and Nelson B. Schiller, MD, and Sadia Ali, MD, MPH, of UCSF. The lead author was Mary Whooley, MD, of UCSF and SFVAMC.