Cardiovascular Reactivity in Posttraumatic Stress Disorder and Depression

Exaggerated cardiovascular reactivity (CVR) to stress has been implicated in the increased risk for cardiovascular disease (CVD) in individuals with posttraumatic stress disorder (PTSD), yet mixed results have been reported. The CVR research may have been confounded by underrepresentation of women, few studies using sophisticated cardiovascular measurement, and a lack of analyses of PTSD symptom clusters. The purpose of the present study was to examine if young civilian women (M ± SD = 29.89±7.33) with PTSD (n=17) demonstrate greater CVR than women with depression (n=12) or no mental illness controls (n=18), and to explore the relationships between CVR and PTSD symptom clusters. Participants were 56% Caucasian, 21% African American, 19% Hispanic, and 4% other. Systolic and diastolic blood pressure (SBP and DBP), heart rate (HR), and impedance cardiography derived cardiac output (CO) and total peripheral resistance (TPR) were utilized to examine CVR during speech preparation/delivery and math tasks. Between-group effects were observed during speech preparation - specifically, lower DBP reactivity for the PTSD group compared to the depression group (p \u3c .05). Between-group effects were also evident during speech delivery, with a trend toward lower DBP reactivity for the PTSD group than the depression group (p \u3c.08), higher CO reactivity for the PTSD group than controls (p \u3c.01), and lower TPR reactivity for the PTSD group than the depression (p \u3c.01) and control groups (p \u3c.01). PTSD severity scores for DSM-IV-TR and DSM-5 were used as independent predictors of CVR in multiple regressions variables. The DSM-IV analysis did not provide significant associations. The DSM-5 yielded significant associations of avoidance and arousal clusters with SBP reactivity during math, a significant association avoidance with DBP reactivity during math, and significant associations of avoidance and arousal with HR reactivity during math. Further exploration of PTSD symptom clusters may provide a clearer picture of the relationship between PTSD/CVR. Higher reactivity and lower reactivity may both be associated with risk for CVD, albeit through separate mechanisms