PTSD ups risk of stroke, transient ischaemic attack

Post-traumatic stress disorder (PTSD) contributes to an increased risk of developing ischaemic stroke and transient ischaemic attack (TIA) in young and middle-aged individuals, independent of established risk factors, coexisting psychiatric disorders and healthcare utilization, a study has found.

The prospective study involved a cohort of 987,855 young and middle-aged veterans (mean age, 30.29 years; 87.8 percent male; 64.4 percent white). Of these, 28.6 percent developed PTSD during the 13-year follow-up. Comorbidities and pharmacological treatment were more common in those with vs without PTSD.

Over the follow-up, 766 and 1,877 patients were diagnosed with TIA and ischaemic stroke, respectively. The corresponding incidence rates were 2.65 and 7.11 events per 10,000 person-years. The cumulative risk of TIA was marginally higher in the PTSD group vs controls in the first 4 years of follow-up (p=0.05). Likewise, PTSD patients had a greater cumulative risk of ischaemic stroke (p<0.0001).

In multivariate Cox models, PTSD was associated with increased risks of incident TIA (hazard ratio [HR], 1.61, 95 percent CI, 1.27–2.04) and ischaemic stroke (HR, 1.36, 1.22–1.52). Notably, the effect of PTSD on ischaemic stroke risk was more pronounced in men than in women (HR, 0.63, 0.47–0.86; p=0.003). This effect of sex was not seen for TIA.

The present data point to psychological factors, including PTSD, as important targets for future age-specific prevention strategies for young adults, according to researchers. This provides a great opportunity to improve stroke prevention in young adults through the development of targeted screening programmes, tailored patient counselling on individual risks, and age-appropriate interventions.