Posttraumatic stress and cardiovascular disease risk.

A growing literature indicates that posttraumatic stress is associated with cardiovascular risk and cardiovascular disease (CVD). Research on specific CVD risk factors and their prevalence in posttraumatic stress disorder (PTSD) may improve understanding of CVD development in this population. The primary purpose of the present article is to outline the evidence relating posttraumatic stress to CVD risk, with an emphasis on behavioral factors. The evidence concerning potential elevations in traditional cardiovascular risk factors with behavioral components in PTSD is reviewed. Brief discussions of autonomic nervous system hyperarousal and immune dysfunction as potential mechanisms for CVD risk are also presented. Together, the available evidence suggests that multiple related risk factors and physiological systems may impact health in PTSD. Based on the literature to date, it is suggested that additional studies are needed on the synergistic effects of multiple interacting CVD risk factors and interventions aimed at primary and secondary prevention of cardiovascular risk.