Observational studyJournal of the American Heart Association2016
Posttraumatic Stress Disorder Is Associated With Worse Endothelial Function Among Veterans.
Observational study in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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
32 citing papers in PubMed, 57 citations in OpenAlex.
- Acute effects of device-guided slow breathing on sympathetic nerve activity and baroreflex sensitivity in posttraumatic stress disorder.American journal of physiology. Heart and circulatory physiology · 2018Trial
- Post-Traumatic Stress Disorder and Atherosclerosis: Co-Phenomena, or Cause-and-Effect?Current atherosclerosis reports · 2026Review
- 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
- Sex Differences in Cardiovascular Disease Outcomes After Traumatic Brain Injury.JACC. Advances · 2026Article
- Mechanisms and Clinical Implications of the Post-traumatic Stress Disorder (PTSD)-Cardiovascular Disease Link.Cureus · 2025Review
- Post-Traumatic Stress Disorder (PTSD) and Cardiovascular Diseases: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Biomarkers and Mechanisms of Cardiovascular Susceptibility and Resilience to Post-Traumatic Stress Disorder.Reviews in cardiovascular medicine · 2025Review
- Behavioural Cardiology: A Review on an Expanding Field of Cardiology-Holistic Approach.Journal of personalized medicine · 2025Review
- Posttraumatic stress disorder increases thrombosis risk: Evidence from a biobank data set.American journal of hematology · 2024Article
- Higher arterial stiffness and blunted vagal control of the heart in young women with compared to without a clinical diagnosis of PTSD.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Article
- Molecular signatures of post-traumatic stress disorder in war-zone-exposed veteran and active-duty soldiers.Cell reports. Medicine · 2023Article
- The association of post-traumatic stress disorder with glomerular filtration rate decline.Nephrology (Carlton, Vic.) · 2023Article
- PTSD, Immune System, and Inflammation.Advances in experimental medicine and biology · 2023Article
- Vagal control moderates the association between endothelial function and PTSD symptoms in women with T2DM.Brain, behavior, & immunity - health · 2022Article
- Cerebral Blood Flow in Predator Stress-Resilient and -Susceptible Rats and Mechanisms of Resilience.International journal of molecular sciences · 2022Article
- Post-traumatic stress disorder (PTSD) as a systemic disorder: Pathways to cardiovascular disease.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2022Review
- Impact of acute antioxidant supplementation on vascular function and autonomic nervous system modulation in young adults with PTSD.American journal of physiology. Regulatory, integrative and comparative physiology · 2021Article
- Key dimensions of post-traumatic stress disorder and endothelial dysfunction: a protocol for a mechanism-focused cohort study.BMJ open · 2021Article
- The intersection of depression, anxiety, and cardiovascular disease among black populations amid the COVID-19 pandemic.Journal of clinical nursing · 2021Article
- Post-traumatic stress disorder and its association with stroke and stroke risk factors: A literature review.Neurobiology of stress · 2021Review
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundCurrent research in behavioral cardiology reveals a significant association between posttraumatic stress disorder (PTSD) and increased risk for cardiovascular disease and mortality; however, the underlying mechanisms remain poorly understood. We hypothesized that patients with PTSD would exhibit endothelial dysfunction, a potential mechanism involved in the development and progression of cardiovascular disease. METHODS AND
resultsA total of 214 outpatients treated at the San Francisco Veterans Affairs Medical Center underwent tests of endothelial function and evaluation for PTSD. Flow-mediated vasodilation of the brachial artery was performed to assess endothelial function, and current PTSD status was defined by the PTSD Checklist, based on the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), with a score ≥40. Multivariable linear regression models were used to estimate the association between PTSD status and endothelial function. Patients with PTSD (n=67) were more likely to be male (99% versus 91%, P=0.04) and to have depression (58% versus 8%, P<0.0001) and were less likely to be on an angiotensin-converting enzyme inhibitor (17% versus 36%, P=0.007) or β-blocker treatment (25% versus 41%, P=0.03). Univariate analysis demonstrated that patients with PTSD had significantly lower flow-mediated vasodilation (5.8±3.4% versus 7.5±3.7%; P=0.003); furthermore, lower flow-mediated vasodilation was associated with increasing age (P=0.008), decreasing estimated glomerular filtration rate (P=0.003), hypertension (P=0.002), aspirin (P=0.03), and β-blocker treatments (P=0.01). In multivariable analysis, PTSD remained independently associated with lower flow-mediated vasodilation (P=0.0005).
conclusionsAfter adjusting for demographic, comorbidity, and treatment characteristics, PTSD remained associated with worse endothelial function in an outpatient population. Whether poor endothelial function contributes to the higher risk of cardiovascular disease in patients with PTSD deserves further study.
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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.