Key takeaways
- The majority of people experience trauma in their lives, and for those who develop post-traumatic stress disorder, the risk of cardiovascular disease goes up as much as 60%.
- UCLA clinical psychologist Dr. Jennifer Sumner's lab finds that a mental health treatment — antidepressant medication — helps reduce the risk of cardiovascular disease.
- The Sumner Stress Lab found that for women veterans, antidepressants halved the risk of developing cardiovascular disease over a five-year period, compared with women veterans not prescribed antidepressant medication.
UCLA researchers are finding new treatments to ease the physical ailments caused by post-traumatic stress disorder. Their studies show that addressing the mental effects of trauma early on may help reduce risk of one such PTSD-linked complication: cardiovascular disease.
"The majority of people will undergo a traumatic event at least once in their lifetime," said UCLA clinical psychologist Dr. Jennifer Sumner. "Our goal is to improve the lives of people who experience trauma."
From car accidents to combat, trauma comes in many forms. It can start with physical pain, such as from an assault or injury, or from mental pain, such as fear during a natural disaster or grief from the unexpected death of a loved one. And for some, their initial reactions – nightmares, jumpiness, intrusive thoughts about the trauma – don't ease up without treatment.
"When those feelings don't go away after more than a month, doctors can diagnose PTSD," Sumner said. "Many of the common ways of coping, such as ignoring it, end up backfiring and making the experience worse."
Research shows that when PTSD develops, the risk of cardiovascular disease goes up, with studies finding finding a 50%-60% increased risk of developing coronary heart disease. Sumner's research has looked at the general population, but also specific groups who have often been understudied and yet carry unique vulnerability for adverse mental and cardiovascular health after trauma. For example, women have distinct risks for poor mental and cardiovascular outcomes following trauma exposure, but have traditionally been underrepresented in research studies.
The Sumner Stress Lab has found that providing mental health treatment can offset that risk and reduce the chance of developing cardiovascular disease, such as strokes, heart attacks or the narrowed arteries of coronary heart disease. In a sample of more than 600,000 women veterans from the U.S. Veterans Health Administration, Sumner's lab found that antidepressants reduced the onset of cardiovascular disease, especially in patients who had PTSD, anxiety and/or depression.
Working with Dr. Ramin Ebrahimi, a cardiologist at UCLA and the U.S. Department of Veterans Affairs, Sumner and her team examined the rates of cardiovascular disease onset in these women for years after being prescribed antidepressant medication. Their study showed that antidepressants halved the risk of developing cardiovascular disease over a five-year period for women veterans, compared with women veterans not prescribed antidepressant medication.
Sumner and her colleagues are also now studying how receiving leading psychotherapies and/or antidepressants for PTSD may impact cardiovascular disease risk in men and women veterans. The new study examines health data from more than three times as many VA patients as the previous research – roughly 2 million people with PTSD. Sumner's team will review the relationship between cardiovascular disease risk and the "gold-standard" treatments for PTSD, including trauma-focused psychotherapies like prolonged exposure and cognitive processing therapy, along with antidepressants.
"There have been major efforts to make these psychotherapy treatments widely available in the VA, and thus we have a unique opportunity to examine how these leading treatments may impact cardiovascular health – something we couldn't do easily in such a large sample without the VA data," Sumner said.
Addressing the mental health consequences of trauma may be an important preventative step for heart health that can have big benefits years later, Sumner said. Because PTSD is such a widespread reaction to trauma, and so many people experience some form of trauma, her work can help hundreds of thousands of people nationwide. Sumner's research, including the veteran study, has been supported by multiple competitive federal grants from the National Institutes of Health in the decade since she received her first postdoctoral grant from NIH.
"The funding we receive from taxpayers means we have a responsibility to create this knowledge and improve the health of the public at large," Sumner said. "I do a lot of community-based outreach to share the impacts of trauma on both mental and cardiovascular health, and to share how these findings can inform healthcare. Doctors can be on the lookout with more targeted screenings to reduce the risk of cardiovascular disease."
Sumner's lab also examines some of the underlying causes of the cardiovascular risks. Some of it may be related to the greater likelihood of people with PTSD to smoke more, exercise less, consume more alcohol and eat unhealthier foods, likely as a coping mechanism, Sumner said.
"We also see signs that there is a physiological component," Sumner added. "We've demonstrated that there's greater systemic inflammation in people with PTSD. Inflammation can contribute to other health issues, including cardiovascular disease and accelerated aging, both of which we see in patients with PTSD."
More studies are needed to better pinpoint why trauma increases the risk of cardiovascular disease, and to more thoroughly understand which treatments provide the best benefits for people in different situations or from different backgrounds, Sumner said. She's confident that more research will expand knowledge, improve health care and improve lives.
