Posttraumatic stress disorder (PTSD) significantly raises the risk of premature death from heart disease, according to results of a long-term study of Vietnam veterans.

In the study, veterans who experienced PTSD were roughly twice as likely to die from heart disease during follow up as veterans without PTSD.

Until now, the evidence linking PTSD with cardiovascular disease was inconclusive, “but this study confirms that PTSD is a major cause of heart disease,” Dr. Joseph Boscarino told Reuters Health. He equates PTSD to smoking two to three packs of cigarettes per day for more than 20 years.

Boscarino from the Center for Health Research, Geisinger Clinic, Danville, Pennsylvania, followed more than 4,300 male Vietnam veterans who did not have heart disease in 1985. The men were younger than age 65 at follow up at the end of 2000.

After controlling for key factors that might influence the results, Boscarino found that having PTSD was associated with a greater than twofold increased risk of death from heart disease in these soldiers.

“Men in the study, on average, were in their mid 50s. Yet they were developing heart disease from PTSD and dying too early,” Boscarino noted.

PTSD causes the body to release stress hormones, which leads to inflammation and damage to the arteries and cardiovascular system. Stress hormones also tend to reduce the amount of cortisol in the body, a hormone that fights inflammation.

“The science is conclusively showing that if you suffer psychological trauma, it’s going to take a toll on your physical health,” Boscarino said. “Getting counseling today is critical to avoiding a related problem tomorrow.”

Boscarino also thinks doctors should be aware of PTSD as a risk factor for heart disease, “just like they are for smoking, cholesterol, etc.”

SOURCE: Psychosomatic Medicine, July/August 2008.