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Abstract

Objective: Kibler et al. (2009) reported that hypertension was related to PTSD independent of depression. These two conditions have significant diagnostic overlap. The present study sought to conceptually replicate this work with a veteran sample, using Bayesian estimation to directly update past results, as well as examine symptom severity scores in relation to hypertension. Method: This was a secondary analysis of data obtained from the United States-Veteran Microbiome Project. Lifetime diagnoses of PTSD and major depressive disorder (MDD) were obtained from a structured clinical interview and hypertension diagnoses were extracted from electronic medical records. PTSD and depressive symptom severity were obtained from self-report measures. Logistic regressions with Bayesian estimation were used to estimate the associations between hypertension and (a) psychiatric diagnostic history and (b) symptom severity scores. Results: Compared with veterans without lifetime diagnoses of either disorder, the PTSD-only group was estimated to have a 29% increase in hypertension risk, and the PTSD + MDD group was estimated to have a 66% increase in hypertension risk. Additionally, higher levels of PTSD symptom severity were associated with a higher risk of hypertension. Conclusion: PTSD diagnosis and symptom severity are uniquely associated with hypertension, independent of MDD or depressive symptom severity. These results support previous findings that PTSD might be a modifiable risk factor for the prevention and treatment of hypertension.Clinical Impact StatementPTSD and depression are both associated with hypertension, a leading risk factor for heart disease, stroke, and death. However, PTSD and depression often occur together and have similar symptoms, making it unclear if each disorder contributes to hypertension. This study of U.S. Military veterans was conducted to explore the potentially unique relationship that each disorder might have with hypertension. Findings suggested that a history of PTSD was linked with elevated risk of hypertension. Treating PTSD might help prevent hypertension, as well as associated outcomes related to this condition.

Authors

Reis, Daniel J.;  Kaizer, Alexander M.;  Kinney, Adam R.;  Bahraini, Nazanin H.;  Forster, Jeri E.;  Brenner, Lisa A.

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