There are few acute medical conditions more devastating than a stroke. Contrary to popular belief, not all stroke victims are elderly. In fact, over a third of all patients hospitalized due to stroke are less than sixty-five years of age. We typically think of stroke victims as having risk factors such as smoking and high blood pressure. However, a commonly overlooked risk factor for stroke is Post-traumatic stress disorder or PTSD. PTSD is a condition marked by strong physiological responses to a previously experienced traumatic event. Such responses, such as recurring nightmares and flashbacks, can be highly debilitating. A literature review published in May 2021 aimed to understand the association between PTSD and stroke.
This review highlights multiple studies showing that PTSD is linked to risk factors that can contribute to the development of stroke. For example, there is strong evidence from a systematic review that included 45 studies that demonstrated a high potential for a causal link between smoking and PTSD. Smoking is a significant risk factor for stroke and is extremely harmful to health in general. Multiple meta-analyses demonstrate that other risk factors for stroke are commonly associated with PTSD as well, such as obesity, high blood pressure, and diabetes.
Certain associations are less understood, and their underlying mechanisms are yet to be defined. It is well known that having heart arrhythmias such as atrial fibrillation (AF) can increase your risk of stroke. The results of a large cohort study of over 1 million young and middle-aged adults published in 2019 demonstrated an association between PTSD and early onset of AF.
The impact of PTSD can be extremely severe and last for decades after the original traumatic event. This work demonstrates that PTSD is far more than just an augmented stress response or psychological phenomenon, but rather a very real illness that has the potential to produce devastating physical and neurological consequences. Given the significant association between PTSD and stroke, healthcare providers should consider the use of screening tools to assess the presence of prior trauma in those who have experienced a stroke and pay close attention to the interplay that may exist between past trauma and many known cardiovascular risk factors.
Sources: CDC, NIH, Journal of the American Heart Association,