A Prospective Study of Posttraumatic Stress Disorder Symptoms and Coronary Heart Disease in Women

Objective: Posttraumatic stress disorder (PTSD) reflects a prolonged stress reaction and dysregulation of the stress response system and is hypothesized to increase risk of developing coronary heart disease (CHD). No study has tested this hypothesis in women even though PTSD is more prevalent among women than men. This study aims to examine whether higher levels of PTSD symptoms are associated with increased risk of incident CHD among women. Design: A prospective study using data from women participating in the Baltimore cohort of the Epidemiologic Catchment Area study (n = 1059). Past year trauma and associated PTSD symptoms were assessed using the NIMH Diagnostic Interview Schedule. Main Outcome Measures: Incident CHD occurring during the 14-year follow-up through 1996. Results: Women with five or more symptoms were at over three times the risk of incident CHD compared with those with no symptoms (age-adjusted OR = 3.21, 95% CI: 1.29-7.98). Findings were maintained after controlling for standard coronary risk factors as well as depression or trait anxiety. Conclusion: PTSD symptoms may have damaging effects on physical health for civilian community-dwelling women, with high levels of PTSD symptoms associated with increased risk of CHD-related morbidity and mortality.