ArticleJournal of the American College of Cardiology2013
Post-traumatic stress disorder and incidence of coronary heart disease: a twin study.
Article in Journal of the American College of Cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 146 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
146 citing papers in PubMed, 4 syntheses or guidelines pooled it, 240 citations in OpenAlex.
- Prevalence and incidence of post-traumatic stress disorder and symptoms in people with chronic somatic diseases: A systematic review and meta-analysis.Frontiers in psychiatry · 2023Pooled it
- Posttraumatic Stress Disorder Treatment Effects on Cardiovascular Physiology: A Systematic Review and Agenda for Future Research.Journal of traumatic stress · 2021Pooled it
- Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues.Annual review of clinical psychology · 2015Pooled it
- Posttraumatic stress disorder and risk for coronary heart disease: a meta-analytic review.American heart journal · 2013Pooled it
- Early Life Trauma Is Associated With Increased Microvolt T-Wave Alternans During Mental Stress Challenge: A Substudy of Mental Stress Ischemia: Prognosis and Genetic Influences.Journal of the American Heart Association · 2022Trial
- Depression and Anxiety Screens as Simultaneous Predictors of 10-Year Incidence of Diabetes Mellitus in Older Adults in Primary Care.Journal of the American Geriatrics Society · 2017Trial
- Post-Traumatic Stress Disorder and Atherosclerosis: Co-Phenomena, or Cause-and-Effect?Current atherosclerosis reports · 2026Review
- Longitudinal Changes in Inflammation-Related Methylation Risk Score for C-Reactive Protein Among People with HIV.Epigenomes · 2026Article
- Association of Type D Personality and Anatomical Complexity as Predictors of Long-Term Mortality in Coronary Artery Disease: A Retrospective Case Study Based on Hospital Records.Diseases (Basel, Switzerland) · 2026Article
- Article
- Cardiac event-induced PTSD symptoms and continuous heart rate in coronary artery disease patients.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2026Article
- Lack of relationship between posttraumatic stress disorder and coronary atherosclerotic burden among twin veterans from the Vietnam era.American journal of epidemiology · 2026Article
- Review
- Post-Traumatic Stress Disorder (PTSD) and Cardiovascular Diseases: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- The brain-heart axis: integrative cooperation of neural, mechanical and biochemical pathways.Nature reviews. Cardiology · 2025Review
- Designing and developing a prescription digital therapeutic for at-home heart rate variability biofeedback to support and enhance patient outcomes in post-traumatic stress disorder treatment.Frontiers in digital health · 2025Article
- Post traumatic stress disorder associated hypothalamic-pituitary-adrenal axis dysregulation and physical illness.Brain, behavior, & immunity - health · 2024Review
- The association between patterns of exposure to adverse life events and the risk of chronic kidney disease: a prospective cohort study of 140,997 individuals.Translational psychiatry · 2024Article
- Posttraumatic Stress Disorder and Obstructive Sleep Apnea in Twins.JAMA network open · 2024Article
- Cortico-limbic interactions and carotid atherosclerotic burden during chronic stress exposure.European heart journal · 2024Article
86 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesThe aim of this study was to determine whether post-traumatic stress disorder (PTSD) is associated with coronary heart disease (CHD) using a prospective twin study design and objective measures of CHD.
backgroundIt has long been hypothesized that PTSD increases the risk of CHD, but empirical evidence using objective measures is limited.
methodsWe conducted a prospective study of middle-aged male twins from the Vietnam Era Twin Registry. Among twin pairs without self-reported CHD at baseline, we selected pairs discordant for a lifetime history of PTSD, pairs discordant for a lifetime history of major depression, and pairs without either condition. All underwent a clinic visit after a median follow-up of 13 years. Outcomes included clinical events (myocardial infarction, other hospitalizations for CHD and coronary revascularization) and quantitative measures of myocardial perfusion by [(13)N] ammonia positron emission tomography, including a stress total severity score and coronary flow reserve.
resultsA total of 562 twins (281 pairs) with a mean age of 42.6 years at baseline were included in this study. The incidence of CHD was more than double in twins with PTSD (22.6%) than in those without PTSD (8.9%; p < 0.001). The association remained robust after adjusting for lifestyle factors, other risk factors for CHD, and major depression (odds ratio: 2.2; 95% confidence interval: 1.2 to 4.1). Stress total severity score was significantly higher (+95%, p = 0.001) and coronary flow reserve was lower (-0.21, p = 0.02) in twins with PTSD than in those without PTSD, denoting worse myocardial perfusion. Associations were only mildly attenuated in 117 twin pairs discordant for PTSD.
conclusionsAmong Vietnam-era veterans, PTSD is a risk factor for CHD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.