Recent research has shown that the civilians involved in the clean up of ‘Ground Zero’ following the World Trade Centre attacks, had a two-fold prevalence of PTSD than that of the general population, and subsequently an increased risk of heart attack and stroke.
The September 11th attacks, which occurred over 16 years ago, required an extensive clean up operation, and for the men and women involved, the study showed that about 20% of the men, and 26% of the women had PTSD during the study. This is a rate roughly double that of the general population.
What was involved in the study?
The study with the World Trade Centre-Heart (a cohort study specifically designed to assess the association between early response to the WTC September 11 attack and cardiovascular outcomes) included non-firefighter workers and untrained volunteers, and cited ‘rates of heart attack were 2.22 times higher among study participants with PTSD compared to those without it, and rates of stroke were 2.51 times higher with PTSD’.
The research published in July 2018 in the journal Circulation: Cardiovascular Quality and Outcomes comprised of 6,841 of the so-called ‘blue-collar’ workers who were involved in the cleaning of the debris during the months immediately after the attack. It showed that neither exposure to dust, nor depression could explain the findings – and concluded that “everyone suffering from PTSD, whether they are men or women… are at higher risk of heart attack and stroke”.
How are PTSD and heart conditions linked?
The study senior author and professor of epidemiology at City University of New York, Alfredo Morabia, suggests the link may come from the fact that PTSD “may stimulate the production of inflammatory cells that then go into the blood vessels and create atherosclerosis.”
Furthermore, Dr. Aaron Pinkhasov (Chairman of behavioral health at NYU Winthrop in Mineola) noted that ‘PTSD can trigger a number of biological responses that might explain the association between PTSD and heart disease and stroke’.
Whilst many people are aware that involvement with a terrorist attack can cause PTSD, it can arise after experiencing or witnessing any threat to life. It can happen to anyone after enduring a terrible event in their life. This may also include losing a loved one, sexual assaults, natural disaster, serious road accidents, robberies, or violent attacks. People with PTSD often feel terrified, anxious and stressed long after the initial trauma has passed and they can be plagued by flashbacks, nightmares, trouble sleeping and other distressing symptoms.
What does this mean for people suffering from PTSD?
Obviously the implications for this study goes beyond those involved in the New York attacks. Similar studies have shown that Post Traumatic Stress Disorder can contribute to a higher risk of myocardial infarction or stroke – but this latest study gives more weight and evidence to this theory. Unfortunately, however, despite the wealth of evidence, as yet, PTSD is still not recognized as a risk factor for cardiovascular disease because available studies are all affected by 1 or several limitations.
Ongoing research into ‘co-morbid’ conditions for PTSD is always vital, and whilst this new research is useful to understand more about the condition, it’s also a useful reminder to everyone, particularly those with PTSD to try to ‘reduce their classic risk factors for cardiovascular disease, such as smoking, high cholesterol and high blood pressure.’
Useful ongoing research would be to find out whether the treatment of PTSD would lead to a reduction in the cardiovascular risk, but either way Both Morabia and Pinkhasov agreed that medical professionals need to be aware of this link when treating people with PTSD.
IMAGE: New York City by Jörg Schubert