Increased Risk of Heart Disease After Post-Traumatic Stress Disorder in Women: Role of Gonadal Hormones and Potential Preventive Interventions
Abstract
In women, cardiovascular disease (CVD) and post-traumatic stress disorder (PTSD) often co-occur. It is known today that the diagnosis of PTSD precedes CVD, which suggests that being diagnosed with PTSD may render an individual at a higher risk for developing CVD. The joint diagnosis is currently treated separately since little is known regarding the mechanisms that link them. PTSD is a mental disorder that can result from experiencing trauma and can manifest as hyperarousal, avoidance, intrusive memories, and abnormalities in fear responses. Of interest is that women are twice as likely as men to develop PTSD after trauma, and heart disease is the leading cause of mortality and disability in women. Together, these suggest that a trait inherent in being female might modulate the risks for CVD in women with PTSD and that, perhaps, treatment should be sex dependent. As of fiscal year 2018, women accounted for 17.7% of the active duty Army and 32.1% of the Army Reserve, and are the fastest growing group of military Veterans. In addition, military women are not only at a higher risk for general trauma compared to civilians, they are also at a higher risk for sexual trauma as 71% of military women suffer from sexual assault. For this reason, military women are at a substantially high risk for developing PTSD, which in turn increases their risk for later CVD. It is critical for the military to develop interventions tailored to women that can prevent the development of PTSD after trauma, detect early risks for CVD after PTSD, and treat both diagnoses jointly since they may share a common etiology when comorbid. The proposed studies in the application seek to determine whether high levels of female sex hormones (estrogen, progesterone) on the day of trauma increases an individual’s risk for developing PTSD and, if so, whether the hormones alter brain composition to later manifest as PTSD symptoms and traits characteristic of CVD. Preliminary data strongly support that high sex hormones on the day of trauma increases the risk for PTSD in females and that trauma is capable of altering molecules in brain. Based on this, we also propose a second study that will investigate whether blocking the action of sex hormones on the day of trauma will mitigate the deleterious effects that hormones have on the development of PTSD and subsequent CVD in females. If successful, the findings will provide: (1) an intervention soon after trauma to prevent development of PTSD and CVD that is portable, inexpensive, and with no harmful side effects, (2) information on early signs of CVD that could be used to develop a tool for early CVD detection after PTSD, and (3) foundation for future work aimed at finding a treatment for CVD for women with PTSD.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010066
Entities
People
- Chieh Chen
Organizations
- Texas A&M Health Science Center
- United States Army