Blunted Brachial Blood Flow Velocity Recovery to Acute Mental Stress in Young Women with PTSD Compared to Controls

Abstract

Introduction: Post-traumatic stress disorder (PTSD) is a debilitating mental illness associated with increased cardiovascular disease (CVD) risk, a major cause of death among women in the United States. Women are twice as likely as men to develop PTSD after trauma exposure, and cardiovascular reactivity to stress is a known risk factor for CVD. Therefore, our aim was to investigate if young women diagnosed with PTSD will present with impaired hemodynamic responses to acute stress compared to controls. We hypothesized that women with PTSD will have high blood pressure (BP), heart rate (HR) and blood flow velocity (BFV) response to a mental stress protocol, and a blunted recovery. Methods: We recruited for this study ten young women with PTSD and nine trauma-exposed women without PTSD (controls) between the ages of 18 to 40 years. We collected data in a single laboratory visit after informed consent and PTSD symptoms severity questionnaire. After demographics and resting hemodynamics, we continuously measured HR using a three-lead EKG, beat-to-beat BP using finger plethysmography and continuous brachial BFV using Doppler ultrasound. A Doppler audio translator was used to transfer the doppler signal in our data analysis software for simultaneous recording of all hemodynamics variables. All variables were recorded during 5 min of supine rest, 5 min of mental stress (via mental arithmetic) and 5 min of recovery. The response and recovery to stress was analyzed using an analysis of covariance with timepoint as within factor and PTSD diagnosis as between-factor. Results: Women with a clinical diagnosis of PTSD had a mean age of 27±10 years and body mass index (BMI) of 30.1±2.9 kg/m2. Controls (trauma-exposed women without PTSD) had a mean age of 26±7 years and body mass index (BMI) of 24± 2.1 kg/m2. Resting seated BP and HR were not different between the groups. The slopes of the overall changes in BFV from baseline to mental stress to recovery were different between young women with PTSD and controls (timepoint*group, P= 0.057) when controlling for PTSD symptoms severity. Specifically, although mental stress elicited similar increases in BFV in women with PTSD (Δ0.80±1.8 cm/sec) and in controls [Δ0.45±1.2 cm/sec, P= 0.44 (timepoint*group)], BFV recovery from stress was impaired in PTSD (Δ0.64±1.3 cm/sec), but not in controls [Δ-2.20±0.84 cm/sec, P= 0.047 (timepoint*group)]. BP and HR reactivity to mental stress and recovery were not different between the groups (P>0.05). Conclusion: The current pilot study revealed that PTSD is associated with blunted recovery from acute mental stress, suggesting early impairment of vascular function in these women at a young age. Young pre-menopausal women are overlooked in prevention strategies and health policies targeting populations at-risk for CVD; with the rising prevalence of trauma exposure in young women, evidence is pointing to a parallel increase in CVD risk. K01HL161027 and UMN CTSI UL1TR002494 No Disclosure. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.