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Advantages of Twin Research
- Categorized in: August 2013, Department of Defense (DoD), Department of Veterans Affairs (VA), PTSD, TBI
For the PTSD study, led by researchers from the Emory University Rollins School of Public Health in Atlanta, heart disease was assessed in 562 middle-age twins — 340 identical and 222 fraternal — from the Vietnam Era Twin Registry. They found that the incidence of heart disease was 22.6% in twins with PTSD, representing 177 individuals, and 8.9% percent in those without PTSD, representing 425 individuals. Heart disease was defined as having a heart attack, having an overnight hospitalization for heart-related symptoms or having undergone a heart procedure.
In addition, positron emission tomography revealed that PTSD patients had almost twice as many areas of reduced blood flow to the heart as individuals without PTSD.
“This study suggests a link between PTSD and cardiovascular health,” said lead researcher Viola Vaccarino, MD, PhD. “For example, repeated emotional triggers during everyday life in persons with PTSD could affect the heart by causing frequent increases in blood pressure, heart rate and heartbeat rhythm abnormalities that in susceptible individuals could lead to a heart attack.”
By using twins, both identical and fraternal, researchers were able to control for the influences of genes and environment on the development of heart disease and PTSD. Comparing the 234 twin sets where one brother had PTSD and the other did not, the incidence of heart disease was almost double in those with PTSD compared to those without PTSD — 22.2% vs. 12.8%.
Even after researchers controlled for lifestyle factors such as smoking, physical activity level and drinking, as well as major depression and other psychiatric diagnoses, the effect of PTSD on heart disease remained significant.
In fact, researchers found no link between PTSD and well-documented heart disease risk factors such as a history of hypertension, diabetes or obesity. That suggests the disease might be due to physiologic changes, not lifestyle factors, the authors pointed out.
- Burke JF, Stulc JL, Skolarus LE, Sears ED, et. al. Traumatic brain injury may be an independent risk factor for stroke. Published online before print June 26, 2013, doi: 10.1212/WNL.0b013e318297eecf Neurology 10.1212/WNL.0b013e318297eecf
- Vaccarino V, Goldberg J, Rooks C, Shah AJ, Veledar E, Faber TL, Votaw JR, Forsberg CW, Bremner JD. Posttraumatic Stress Disorder and Incidence of Coronary Heart Disease: A Twin Study. J Am Coll Cardiol. 2013 Jun 26. doi:pii:S0735-1097(13)02506-0. 10.1016/j.jacc.2013.04.085. [Epub ahead of print] PubMed PMID: 23810885.