Stress- and anxiety-related disorders are on the rise in both military and general populations. Over the next decade, it is predicted that treatment of these conditions, in particular, posttraumatic stress disorder (PTSD), along with its associated long-term comorbidities, will challenge the health care system. Multiple organ systems are adversely affected by PTSD, and PTSD is linked to cancer, arthritis, digestive disease, and cardiovascular disease. Evidence for a strong link between PTSD and cardiovascular disease is compelling, and this review describes current clinical data linking PTSD to cardiovascular disease, via inflammation, autonomic dysfunction, and the renin-angiotensin system. Recent clinical and preclinical evidence regarding the role of the renin-angiotensin system in the extinction of fear memory and relevance in PTSD-related immune and autonomic dysfunction is also addressed.
Associated Clinical Trials
Interactions between ANG II, sympathetic nervous system, and baroreceptor reflexes in regulation of blood pressure
Repeated stress increases the density of angiotensin II binding sites in rat paraventricular nucleus and subfornical organ
Diseases among men 20 years after exposure to severe stress: implications for clinical research and medical care
Body weight reduction, sympathetic nerve traffic, and arterial baroreflex in obese normotensive humans
Twenty-four-hour ambulatory blood pressure and heart rate monitoring in combat-related posttraumatic stress disorder
Elevated serum interleukin-6 (IL-6) and IL-6 receptor concentrations in posttraumatic stress disorder following accidental man-made traumatic events
Sleep disturbances and psychiatric disorders associated with posttraumatic stress disorder in the general population
Restraint stress modulates brain, pituitary and adrenal expression of angiotensin II AT(1A), AT(1B) and AT(2) receptors
Comparative effects of candesartan and hydrochlorothiazide on blood pressure, insulin sensitivity, and sympathetic drive in obese hypertensive individuals: results of the CROSS study
Effects of posttraumatic stress disorder on cardiovascular stress responses in Gulf War veterans with fatiguing illness
Interleukin 1 beta enhances conditioned fear memory in rats: possible involvement of glucocorticoids
The inflammatory markers C-reactive protein and serum amyloid A in refugees with and without posttraumatic stress disorder
Risk of selected cardiovascular diseases and posttraumatic stress disorder among former World War II prisoners of war
Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder
External-cause mortality after psychologic trauma: the effects of stress exposure and predisposition
Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study
Angiotensin II AT1 receptor blockade prevents the hypothalamic corticotropin-releasing factor response to isolation stress
Fear conditioning in posttraumatic stress disorder: evidence for delayed extinction of autonomic, experiential, and behavioural responses
Chronic administration of an angiotensin II receptor antagonist resets the hypothalamic-pituitary-adrenal (HPA) axis and improves the affect of patients with diabetes mellitus type 2: preliminary results
Baroreceptor sensitivity at rest and during stress in women with posttraumatic stress disorder or major depressive disorder
Failure of extinction of fear responses in posttraumatic stress disorder: evidence from second-order conditioning
Symptom severity predicts degree of T cell activation in adult women following childhood maltreatment.
Nitric oxide as inflammatory mediator in post-traumatic stress disorder (PTSD): evidence from an animal model.
A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention.
Posttraumatic stress symptoms and predicted mortality in patients with implantable cardioverter-defibrillators: results from the prospective living with an implanted cardioverter-defibrillator study
Hypertension in relation to posttraumatic stress disorder and depression in the US National Comorbidity Survey
Angiotensin II type 1 receptor-mediated reduction of angiotensin-converting enzyme 2 activity in the brain impairs baroreflex function in hypertensive mice.
Autonomic activation during sleep in posttraumatic stress disorder and panic: a mattress actigraphic study.
Association of posttraumatic stress disorder with low-grade elevation of C-reactive protein: evidence from the general population
Heart rate variability in patients with post-traumatic stress disorder or borderline personality disorder: relationship to early life maltreatment
Molecular indicators of stress-induced neuroinflammation in a mouse model simulating features of post-traumatic stress disorder
Baroreflex dysfunction and augmented sympathetic nerve responses during mental stress in veterans with post-traumatic stress disorder.
Posttraumatic stress disorder eliminates association of TrkB rs1187327 with HDL-C in Chinese Han adolescents
Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review
Preliminary Evidence for the Impact of Combat Experiences on Gray Matter Volume of the Posterior Insula
Acute effects of device-guided slow breathing on sympathetic nerve activity and baroreflex sensitivity in posttraumatic stress disorder.
Dysfunctional or hyperfunctional? The amygdala in posttraumatic stress disorder is the bull in the evolutionary China shop
Co-Occurrence of Posttraumatic Stress Disorder and Cardiovascular Disease Among Ethnic/Racial Groups in the United States
Posttraumatic stress disorder diagnosis is associated with reduced parasympathetic activity during sleep in US veterans and military service members of the Iraq and Afghanistan wars
A comparison of physical comorbidities in patients with posttraumatic stress disorder developed after a terrorist attack or other traumatic event
Sex differences in mouse models of fear inhibition: Fear extinction, safety learning, and fear-safety discrimination
Common pathways and communication between the brain and heart: connecting post-traumatic stress disorder and heart failure
Predictors of multiple domains of functioning in Veterans with posttraumatic stress disorder: Results from the Mind Your Heart Study
Sleep disturbance at pre-deployment is a significant predictor of post-deployment re-experiencing symptoms.
Stressful life events and augmentation index: results from the Cardiovascular and Metabolic Diseases Etiology Research Center.
Posttraumatic Stress Disorder and Alterations in Resting Heart Rate Variability: A Systematic Review and Meta-Analysis
Polymorphisms at the F12 and KLKB1 loci have significant trait association with activation of the renin-angiotensin system
Plastics and cardiovascular health: phthalates may disrupt heart rate variability and cardiovascular reactivity
Stress-Induced Sensitization of Angiotensin II Hypertension Is Reversed by Blockade of Angiotensin-Converting Enzyme or Tumor Necrosis Factor-α
Acute Physiological Responses Following a Bout of Vigorous Exercise in Military Soldiers and First Responders with PTSD: An Exploratory Pilot Study
Sleep, a Governor of Morbidity in PTSD: A Systematic Review of Biological Markers in PTSD-Related Sleep Disturbances
Evaluation of posttraumatic stress disorder diagnosis and therapy on diurnal blood pressure patterns from 24-hour ambulatory blood pressure monitoring
Cardiac Arrest and Subsequent Hospitalization-Induced Posttraumatic Stress Is Associated With 1-Year Risk of Major Adverse Cardiovascular Events and All-Cause Mortality
History of Preeclampsia Adds to the Deleterious Effect of Chronic Stress on the Cardiac Ability to Flexibly Adapt to Challenge
Increased H3K4me3 methylation and decreased miR-7113-5p expression lead to enhanced Wnt/β-catenin signaling in immune cells from PTSD patients leading to inflammatory phenotype.
Increased circulating blood cell counts in combat-related PTSD: Associations with inflammation and PTSD severity
Manipulation of rapid eye movement sleep via orexin and GABAA receptor modulators differentially affects fear extinction in mice: effect of stable versus disrupted circadian rhythm.
Emotion regulation and the association between PTSD, diet, and exercise: a longitudinal evaluation among US military veterans.
Post-traumatic stress disorder and its association with stroke and stroke risk factors: A literature review.
Baseline sleep quality moderates symptom improvement in veterans with comorbid PTSD and TBI receiving trauma-focused treatment.
Impact of acute antioxidant supplementation on vascular function and autonomic nervous system modulation in young adults with PTSD.
Posttraumatic Stress Disorder and Cardiovascular Disease: State of the Science, Knowledge Gaps, and Research Opportunities.
Combining Trauma Script Exposure With rTMS to Reduce Symptoms of Post-Traumatic Stress Disorder: Randomized Controlled Trial.
Trans-anethole prevents hypertension induced by chronic exposure to both restraint stress and nicotine in rats
The Association of Posttraumatic Stress Disorder With Longitudinal Change in Glomerular Filtration Rate in World Trade Center Responders.
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