Individuals with posttraumatic stress disorder have increased beat-to-beat blood pressure variability

Abstract

Individuals with posttraumatic stress disorder (PTSD) are at elevated risk for cardiovascular disease (CVD). Emerging research suggests that increased blood pressure variability (BPV) reflects abnormalities in autonomic regulation and may be an early indicator of future CVD risk. PTSD is associated with autonomic dysregulation that is related to PTSD symptoms and is associated with increased risk of CVD; however, BPV in PTSD remains unexplored. We hypothesized that individuals with PTSD would exhibit greater short-term BPV compared with controls and that BPV would correlate with psychological symptoms. Fifty-nine participants (PTSD: n = 38; controls: n = 21) completed beat-to-beat blood pressure recordings via finger photoplethysmography for 5-10 min. BPV indices included standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) for systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure. PTSD symptoms were assessed via the PTSD checklist, fifth edition. Anxiety symptoms were assessed via the State-Trait Anxiety Inventory, and depression symptoms were assessed via Beck's Depression Inventory. Compared with controls, the PTSD group had significantly higher SBP-SD (4.3 ± 1.7 vs. 3.3 ± 1.3 mmHg, P = 0.021), SBP-CV (3.7 ± 1.6 vs. 2.7 ± 1.0 mmHg, P = 0.005), and DBP-CV (4.6 ± 1.4 vs. 3.9 ± 1.4 mmHg, P = 0.045). No group differences were found in ARV measures or cardiac baroreflex sensitivity. BPV was not significantly correlated with PTSD, anxiety, or depression symptoms. In conclusion, individuals with PTSD exhibited greater BPV, but psychological symptoms were not associated with BPV indices.NEW & NOTEWORTHY Individuals with PTSD have higher resting beat-to-beat BPV compared with healthy controls, despite no differences in average blood pressure values. Elevated systolic and diastolic BPV indices showed moderate-to-large effect sizes. BPV indices were not associated with PTSD, anxiety, or depression symptoms. These findings suggest that increased BPV in individuals with PTSD may reflect altered cardiovascular regulation relevant to heightened cardiovascular risk.