Post-traumatic stress disorder as a predictor for incident hypertension: a 3-year retrospective cohort study

2021 ◽  
pp. 1-8
Author(s):  
Victoria Mendlowicz ◽  
Maria Luiza Garcia-Rosa ◽  
Marcio Gekker ◽  
Larissa Wermelinger ◽  
William Berger ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Stress Disorder ◽  
Cox Regression ◽  
Clinical Status ◽  
Family Doctor ◽  
Cox Proportional Hazards ◽  
Post Traumatic Stress ◽  
Incident Hypertension ◽  
Ptsd Diagnosis ◽  
Stressful Environment

Abstract Background The goal of the present study was to investigate the association between PTSD and the onset of hypertension in previously normotensive individuals in a population living in the stressful environment of the urban slums while controlling for risk factors for cardiovascular disease (CVD). Methods Participants were 320 normotensive individuals who lived in slums and were attending a family doctor program. Measurements included a questionnaire covering sociodemographic characteristics, clinical status and life habits, the Posttraumatic Stress Disorder Checklist – Civilian Version, and the Beck Depression Inventory. Incident hypertension was defined as the first occurrence at the follow-up review of the medical records of (1) systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher, (2) the participant started taking antihypertensive medication, or (3) a new diagnosis of hypertension made by a physician. Differences in sociodemographic, clinical, and lifestyle characteristics between hypertensive and non-hypertensive individuals were compared using the χ2 and t tests. Multivariate Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results Six variables – age, educational level, body mass, smoking, diabetes, and PTSD diagnosis – showed a statistically significant (p ≤ 0.20) association with the hypertensive status. In the Cox regression, only PTSD diagnosis was significantly associated with incident hypertension (multivariate HR = 1.94; 95% CI 1.11–3.40). Conclusions The present findings highlight the importance of considering a diagnostic hypothesis of PTSD in the prevention and treatment of cardiovascular diseases.

scholarly journals An epistasis between dopaminergic and oxytocinergic systems confers risk of post-traumatic stress disorder in a traumatized Chinese cohort

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kunlin Zhang ◽  
Gen Li ◽  
Li Wang ◽  
Chengqi Cao ◽  
Ruojiao Fang ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Trauma Exposure ◽  
Environment Interaction ◽  
Post Traumatic Stress ◽  
Ptsd Diagnosis ◽  
Psychiatric Syndrome ◽  
Chinese Cohort ◽  
Post Traumatic

AbstractPost-traumatic stress disorder (PTSD) is a psychiatric syndrome that occurs after trauma exposure. Neurotransmitters such as dopamine and oxytocin have been reported to be involved in neuropathology of PTSD. Previous studies indicated that the dopamine–oxytocin interaction may contribute to behavioral disorders. Thus, exploring the epistasis (gene–gene interaction) between oxytocinergic and dopaminergic systems might be useful to reveal the genetic basis of PTSD. In this study, we analyzed two functional single nucleotide polymorphisms (SNPs), rs2268498 for oxytocinergic gene OXTR and rs1801028 for dopaminergic gene DRD2 based on putative oxytocin receptor–dopamine receptor D2 (OTR–DR2) heterocomplex in a Chinese cohort exposed to the 2008 Wenchuan earthquake (156 PTSD cases and 978 controls). Statistical analyses did not find any single variant or gene–environment interaction (SNP × earthquake-related trauma exposure) associated with provisional PTSD diagnosis or symptoms. An OXTR–DRD2 interaction (rs2268498 × rs1801028) was identified to confer risk of provisional PTSD diagnosis (OR = 9.18, 95% CI = 3.07–27.46 and P = 7.37e-05) and further subset analysis indicated that rs2268498 genotypes controlled the association directions of rs1801028 and rs1801028 genotypes also controlled the association directions of rs2268498. Rs2268498 × rs1801028 is also associated with PTSD symptoms (P = 0.043). Our study uncovered a genetic and putative function-based contribution of dopaminergic–oxytocinergic system interaction to PTSD.

Abstract P100: Long-Term Exposures to Community Noise and Blood Pressure Levels in Chicago, Illinois

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Jennifer C D'Souza ◽  
Jennifer Weuve ◽  
Robert D Brook ◽  
Denis A Evans ◽  
Joel D Kaufman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Air Pollutant ◽  
Cox Proportional Hazards Model ◽  
Noise Levels ◽  
Incident Hypertension ◽  
Community Noise ◽  
The Us

Objectives: Over half the US population experiences noise levels above WHO recommendations yet little research within the US has examined the health effects of these exposures. Our objective is to investigate the associations between community noise and blood pressure in residents of Chicago. Methods: Participants were from two prospective cohort studies: the Multi Ethnic Study of Atherosclerosis (MESA) and the Chicago Health and Aging Project (CHAP). MESA is a multi-site study of persons aged 45-84 years and free of clinical cardiovascular disease. CHAP is an open cohort initiated to study chronic conditions of aging among persons aged ≥65 years. This analysis focuses on the 5,167 participants of these cohorts living in Chicago with an average of 2.5 (CHAP) and 4.5 (MESA) assessments per participant, for systolic (SBP) and diastolic (DBP) blood pressure between 1999-2011. In both cohorts, hypertension was defined as taking antihypertensive medication, SBP ≥140 or DBP ≥ 90 mmHg. We estimated noise at participant addresses using land use regression models weighted according to participants’ 5-year residential history before each exam. Among those taking antihypertensive medication, blood pressure was adjusted using multiple imputation. Associations between noise and blood were estimated using linear mixed models. A Cox proportional hazards model was used to estimate relative risk (RR) of incident hypertension. All models included calendar time, age, sex, race, income, education, neighborhood socioeconomic score, smoking, cohort, interaction between cohort and age, race, and gender, and NO x (a traffic-related air pollutant). Findings : At baseline, MESA participants were younger (63 vs 73 years) and more educated (36 vs. 3% with ≥graduate degree) than CHAP participants. MESA participants had higher noise levels (60 vs 56 dB) and lower blood pressures (e.g. SBP: 124 vs 135 mmHg) than CHAP participants. After adjusting for cohort and other confounders, we found that 10 dB higher residential noise levels were associated with 0.9 (95% CI: -0.2, 0.2; p=0.1) and 0.5 mmHg greater (95% CI: -0.1, 0.11; p=0.08) SBP and DBP, respectively. Similar associations were found within each cohort. Noise was not associated with incident hypertension overall (RR: 1.00; 95% CI: 0.8, 1.3, p=0.98) or within cohort. Conclusions: We found a suggestive association between noise and blood pressure levels, but no association with hypertension. This could be due to the lack of nighttime noise information, which has been shown to be more strongly associated with blood pressure outcomes than daytime levels or with the selection of healthy older participants.

scholarly journals Trajectories of Mediterranean Diet Adherence and Risk of Hypertension in China: Results from the CHNS Study, 1997–2011

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 2014 ◽  
Author(s):  
Min Gao ◽  
Fengbin Wang ◽  
Ying Shen ◽  
Xiaorou Zhu ◽  
Xing Zhang ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Proportional Hazards Model ◽  
Cox Regression ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Nutrition Survey ◽  
Cox Regression Analysis ◽  
Incident Hypertension ◽  
Diet Adherence ◽  
Mediterranean Diet Adherence

Evidence indicates that longitudinal changes in dietary patterns may predict variations in blood pressure (BP) and risk of incident hypertension. We aimed to identify distinct trajectories in the levels of Mediterranean diet adherence (MDA) in China and explore their association with BP levels and hypertension risk using the China Health and Nutrition Survey 1997–2011 data. Three levels of MDA were constructed. The trajectories in these levels were constructed using group-based trajectory modeling. A Cox proportional hazards model was used to measure the association between MDA trajectory groups and the risk of incident hypertension after adjusting for covariates. Finally, 6586 individuals were included. Six distinct MDA trajectory groups were identified: persistently low and gradual decline; rapidly increasing and stabilized; persistently moderate; slightly increasing, steady, and acutely descending; slightly decreasing and acutely elevated; and persistently high. The systolic BP and diastolic BP were significantly lower in trajectory groups with rapidly increasing and stabilized MDA; slightly increasing, steady, and acutely descending MDA; and persistently high MDA. Cox regression analysis showed that the risks of developing hypertension were relatively lower in the group with slightly increasing, steady, and acutely descending MDA (hazard ratio (HR) = 0.17, 95% confidence interval (CI): 0.09–0.32) and the group with rapidly increasing and stabilized MDA (HR = 0.32, 95% CI: 0.23–0.42), but the risk was the highest in the trajectory with persistently moderate MDA (HR = 0.96, 95% CI: 0.84–1.08). In conclusion, MDA in China was categorized into six distinct trajectory groups. BP was relatively lower in trajectory groups with initially high or increasing MDA levels. Greater MDA was significantly associated with a lower risk of developing hypertension.

scholarly journals Diabetic Retinopathy and Risk of Stroke

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3733-3736
Author(s):  
Ka-Ho Wong ◽  
Katherine Hu ◽  
Cecilia Peterson ◽  
Nazanin Sheibani ◽  
Georgios Tsivgoulis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diabetic Retinopathy ◽  
Primary Outcome ◽  
Vision Loss ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Secondary Analysis ◽  
Cox Proportional Hazards ◽  
Increased Risk

Background and Purpose: Diabetic retinopathy (DR) is a common microvascular complication of diabetes, which causes damage to the retina and may lead to rapid vision loss. Previous research has shown that the macrovascular complications of diabetes, including stroke, are often comorbid with DR. We sought to explore the association between DR and subsequent stroke events. Methods: This is a secondary analysis of patients enrolled in the ACCORD Eye study (Action to Control Cardiovascular Risk in Diabetes). The primary outcome was stroke during follow-up. The exposure was presence of DR at study baseline. We fit adjusted Cox proportional hazards models to provide hazard ratios for stroke and included interaction terms with the ACCORD randomization arms. Results: We included 2828 patients, in whom the primary outcome of stroke was met by 117 (4.1%) patients during a mean (SD) of 5.4 (1.8) years of follow-up. DR was present in 874 of 2828 (30.9%) patients at baseline and was more common in patients with than without incident stroke (41.0% versus 30.5%; P =0.016). In an adjusted Cox regression model, DR was independently associated with incident stroke (hazard ratio, 1.52 [95% CI, 1.05–2.20]; P =0.026). This association was not affected by randomization arm in the ACCORD glucose ( P =0.300), lipid ( P =0.660), or blood pressure interventions ( P =0.469). Conclusions: DR is associated with an increased risk of stroke, which suggests that the microvascular pathology inherent to DR has larger cerebrovascular implications. This association appears not to be mediated by serum glucose, lipid, and blood pressure interventions.

scholarly journals Post-Traumatic Stress Disorder and the Risk of Erectile Dysfunction: A Nationwide Cohort Study in Taiwan

2021 ◽  
Author(s):  
Sheng-Chiang Wang ◽  
Wu-Chien Chien ◽  
Chi-Hsiang Chung ◽  
Nian-Sheng Tzeng ◽  
Yia-Ping Liu
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Cohort Study ◽  
Erectile Dysfunction ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Cox Regression ◽  
Geographic Region ◽  
Research Database ◽  
Post Traumatic Stress ◽  
Cox Regression Analysis

Abstract BACKGROUND: This study aimed to investigate the association between posttraumatic stress disorder and the risk of developing erectile dysfunction.METHODS: In this population-based, retrospective cohort study, we used Taiwan’s National Health Insurance Research Database to analyze the patients who were newly diagnosed with posttraumatic stress disorder (PTSD) between 2000 and 2013, with a 1:3 ratio by age, and index year matched in the non-PTSD comparison group, for the risk of erectile dysfunction. RESULTS: In total, five out of 1,079 patients with PTSD developed erectile dysfunction, and three out of 3,237 patients in the non-PTSD group (47.58 vs 9.03 per 100,000 per person-year) developed erectile dysfunction. The Kaplan-Meier analysis showed that the PTSD cohort had a significantly higher risk of erectile dysfunction (log-rank, p<0.001). The Cox regression analysis revealed that the study subjects were more likely to develop an injury (HR: 12.898, 95% CI=2.453- 67.811, p=0.003) after adjusting for age, monthly income, urbanization level, geographic region, and comorbidities. Psychotropic medications in the patients with PTSD were not associated with the risk of erectile dysfunction.CONCLUSIONS: Patients who suffered PTSD had a higher risk of developing erectile dysfunction.

scholarly journals Post-traumatic stress disorder symptoms and risk of hypertension over 22 years in a large cohort of younger and middle-aged women

2016 ◽  
Vol 46 (15) ◽  
pp. 3105-3116 ◽  
Author(s):  
J. A. Sumner ◽  
L. D. Kubzansky ◽  
A. L. Roberts ◽  
P. Gilsanz ◽  
Q. Chen ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Trauma Exposure ◽  
Health Study ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Incident Hypertension ◽  
Post Traumatic ◽  
Antidepressant Use

BackgroundPost-traumatic stress disorder (PTSD) has been linked to hypertension, but most research on PTSD and hypertension is cross-sectional, and potential mediators have not been clearly identified. Moreover, PTSD is twice as common in women as in men, but understanding of the PTSD-hypertension relationship in women is limited. We examined trauma exposure and PTSD symptoms in relation to incident hypertension over 22 years in 47 514 civilian women in the Nurses’ Health Study II.MethodWe used proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for new-onset hypertension (N = 15 837).ResultsPTSD symptoms assessed with a screen were modestly associated with incident hypertension in a dose-response fashion after adjusting for potential confounders. Compared to women with no trauma exposure, women with 6–7 PTSD symptoms had the highest risk of developing hypertension (HR 1.20, 95% CI 1.12–1.30), followed by women with 4–5 symptoms (HR 1.17, 95% CI 1.10–1.25), women with 1–3 symptoms (HR 1.12, 95% CI 1.06–1.18), and trauma-exposed women with no symptoms (HR 1.04, 95% CI 1.00–1.09). Findings were maintained, although attenuated, adjusting for hypertension-relevant medications, medical risk factors, and health behaviors. Higher body mass index and antidepressant use accounted for 30% and 21% of the PTSD symptom-hypertension association, respectively.ConclusionsScreening for hypertension and reducing unhealthy lifestyle factors, particularly obesity, in women with PTSD may hold promise for offsetting cardiovascular risk.

scholarly journals Gene Variation of Endoplasmic Reticulum Aminopeptidases 1 and 2, and Risk of Blood Pressure Progression and Incident Hypertension among 17,255 Initially Healthy Women

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Robert Y. L. Zee ◽  
Alicia Rivera ◽  
Yaritza Inostroza ◽  
Paul M. Ridker ◽  
Daniel I. Chasman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endoplasmic Reticulum ◽  
Regression Analysis ◽  
Cox Regression ◽  
Health Study ◽  
Multivariable Logistic Regression Analysis ◽  
Regression Analyses ◽  
Cox Regression Analysis ◽  
Incident Hypertension ◽  
Gene Variation

Recent studies have demonstrated the importance of endoplasmic reticulum aminopeptidase (ERAP) in blood pressure (BP) homeostasis. To date, no large prospective, genetic–epidemiological data are available on genetic variation within ERAP and hypertension risk. The association of 45 genetic variants of ERAP1 and ERAP2 was investigated in 17,255 Caucasian female participants from the Women’s Genome Health Study. All subjects were free of hypertension at baseline. During an 18-year follow-up period, 10,216 incident hypertensive cases were identified. Multivariable linear, logistic, and Cox regression analyses were performed to assess the relationship of genotypes with baseline BP levels, BP progression at 48 months, and incident hypertension assuming an additive genetic model. Linear regression analyses showed associations of four tSNPs (ERAP1: rs27524; ERAP2: rs3733904, rs4869315, and rs2549782; all p<0.05) with baseline systolic BP levels. Three tSNPs (ERAP1: rs27851, rs27429, and rs34736, all p<0.05) were associated with baseline diastolic BP levels. Multivariable logistic regression analysis showed that ERAP1 rs27772 was associated with BP progression at 48 months (p=0.0366). Multivariable Cox regression analysis showed an association of three tSNPs (ERAP1: rs469783 and rs10050860; ERAP2: rs2927615; all p<0.05) with risk of incident hypertension. Analyses of dbGaP for genotype–phenotype association and GTEx Portal for gene expression quantitative trait loci revealed five tSNPs with differential association of BP and nine tSNPs with lower ERAP1 and ERAP2 mRNA expression levels, respectively. The present study suggests that ERAP1 and ERAP2 gene variation may be useful for risk assessment of BP progression and the development of hypertension.

scholarly journals What Is PTSD? Diagnosis, Treatment, and Challenges

2021 ◽  
Vol 9 ◽  
Author(s):  
Prarthana Pilla ◽  
Janet Y. Le ◽  
Phoebe Lay ◽  
Joyce Tiong ◽  
Nicole Osier
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Healthcare Professionals ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Ptsd Diagnosis ◽  
The Public ◽  
Post Traumatic ◽  
Invisible Disability ◽  
Serious Injury

Post-traumatic stress disorder (PTSD) can occur when someone experiences a scary event or serious injury. This disorder can affect multiple parts of a person’s life, from relationships with loved ones to performance at work. Unfortunately, PTSD is not understood well. It is considered an invisible disability, which means it can be difficult to determine if someone has PTSD just by looking at them, since they have no visible symptoms. Because of the difficulty of diagnosing PTSD, healthcare professionals are working toward checklists that can be used by all doctors for PTSD diagnosis and treatment, which will hopefully improve the care of PTSD patients. Similarly, disability activists continue to raise awareness and educate the public on PTSD. In this article, we will discuss the causes of PTSD, its effects on daily life, diagnosis, treatment, and the importance of showing kindness toward people with this invisible disability.

scholarly journals Incidence of Hypertension among Persons Living with HIV in China A Multicenter Study

2020 ◽  
Author(s):  
Hongwei Fan ◽  
fuping guo ◽  
Evelyn Hsieh ◽  
Wei-Ti Chen ◽  
Wei Lv ◽  
...  
Keyword(s):  
Cox Regression ◽  
Cox Proportional Hazards ◽  
Hiv Care ◽  
Multicenter Studies ◽  
Cox Regression Analysis ◽  
Incident Hypertension ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Prospective Longitudinal

Abstract Objectives Life expectancy among persons living with HIV (PLWH) has improved with increasing access to antiretroviral therapy (ART), however incidence of chronic comorbidities has simultaneously increased. No data are available regarding the incidence of hypertension among Chinese PLWH.Methods We analyzed data collected from patients enrolled in two prospective longitudinal multicenter studies of PLWH initiating ART in China. Incidence rate of hypertension per 100 person-years (PYs) among PLWH was calculated, and Cox proportional hazards models was used to evaluate the association between incident hypertension and traditional and HIV-associated risk factors.Results Of 1078 patients included in this analysis, 984 ART-naïve patients were hypertension-free at baseline, and contributed 2337.7 PYs of follow up, with a median follow-up period of 1.8 years (range: 1.2-3.2) after initiation of ART. Incidence of hypertension was 7.6 [95% confidence interval (CI): 6.5-8.7] per 100 PYs. In the Cox regression analysis, incidence of hypertension was positively associated with BMI [adjusted hazard ratio (aHR) 1.07 (1.01,1.13), p=0.02] and recent viral load (aHR 1.28, 95% CI:1.08-1.51, p=0), and negatively associated with recent CD4+/CD8+ ratio (aHR 0.14, 95% CI:0.06-0.31, p<0.001), zidovudine exposure (aHR 0.15, 95% CI: 0.10-0.24, p<0.001) and tenofovir exposure (aHR 0.13, 95% CI: 0.08-0.21, p<0.001).Conclusions The incidence of hypertension was relatively high among Chinese PLWH initiating ART. Independent risk factors for incident hypertension included recent low CD4+/CD8+ ratio and detectable HIV viremia, whereas receipt of ART was associated with reduced risk. Hypertension may be mitigated, in part, by excellent HIV care, including viral suppression with ART.

scholarly journals A Multi-omics Study of Circulating Phospholipid Markers of Blood Pressure

2021 ◽  
Author(s):  
Jun Liu ◽  
Paul S. de Vries ◽  
Fabiola Del Greco M. ◽  
Åsa Johansson ◽  
Katharina E. Schraut ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Linear Regression ◽  
Cox Regression ◽  
Lipid Lowering ◽  
Testable Hypothesis ◽  
Future Research ◽  
Incident Hypertension ◽  
Cell Counts ◽  
Wide Range ◽  
Insight Into

Abstract Background High-throughput techniques allow us to measure a wide-range of phospholipids which can provide insight into the mechanisms of hypertension. We aimed to conduct an in depth multi-omics study of various phospholipids with systolic blood pressure (SBP) and diastolic blood pressure (DBP).Methods The associations of blood pressure and 151 plasma phospholipids measured by electrospray ionization tandem mass spectrometry were performed by linear regression in five European cohorts (n = 2,786 in discovery and n = 1,185 in replication). We further explored the blood pressure-related phospholipids in Erasmus Rucphen Family (ERF) study by associating them with multiple cardiometabolic traits (linear regression) and predicting incident hypertension (Cox regression). Mendelian Randomization (MR) and phenome-wide association study (pheWAS) were also explored to further investigate these association results.Results We identified six phosphatidylethanolamines (PE 38:3, PE 38:4, PE 38:6, PE 40:4, PE 40:5 and PE 40:6) and two phosphatidylcholines (PC 32:1 and PC 40:5) which together predicted incident hypertension with an area under the curve (AUC) of 0.61. The identified eight phospholipids are strongly associated with triglycerides, obesity related traits (e.g. waist, waist hip ratio, total fat percentage, body mass index, lipid-lowering medication, and leptin), diabetes related traits (e.g. glucose, insulin resistance and insulin) and prevalent type 2 diabetes. The genetic determinants of these phospholipids also associated with many lipoproteins, heart rate, pulse rate and blood cell counts. No significant association was identified by bi-directional MR approach.Conclusion We identified eight blood pressure-related circulating phospholipids that have a predictive value for incident hypertension. Our cross-omics analyses show that phospholipid metabolites in the circulation may yield insight into blood pressure regulation and raise a number of testable hypothesis for future research.

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