PTSD and Cardiovascular Disease
Looking at the Overlap Between Mental and Physical Health
When we talk about post-traumatic stress disorder (PTSD), we often focus on the psychological impact—things like hypervigilance, sleep disruptions, or anxiety. But increasingly, researchers are exploring a deeper question: how might PTSD affect physical health, particularly the heart?
A recent systematic review examined 69 peer-reviewed studies on the topic, and while it doesn’t claim to draw straight lines, it offers an insightful look at how the body and mind may move in tandem more than we tend to realize.
PTSD and Hypertension
According to the U.S. Department of Veterans Affairs, about 6% of people in the U.S. will experience PTSD at some point. Among this population, hypertension (high blood pressure) consistently shows up as a common concern.
Some studies suggest that individuals with PTSD may be nearly twice as likely to develop hypertension. One study, dating back to 2009, even found that PTSD was more strongly associated with hypertension than with depression, a surprising finding that challenges common assumptions about mental health comorbidities.
While this doesn’t mean PTSD directly causes high blood pressure, it does raise important questions about how chronic stress might influence cardiovascular risk.
Stress, Inflammation, and Heart Health
One theory centers on the body’s prolonged stress response. When the sympathetic nervous system (our “fight or flight” wiring) is repeatedly activated, it can fuel chronic inflammation, a process increasingly linked to cardiovascular disease.
Another possible piece of the puzzle? Endothelial dysfunction. I’ve written about it before—it’s a breakdown in the lining of blood vessels that can set the stage for various heart conditions. Long-term stress may play a role here, but again, this is more about patterns and correlations than pinpointing a cause.
Lifestyle Factors and a Snowball Effect
The review also noted a 31% increased risk of weight gain among individuals with PTSD, which can contribute to obesity and, in turn, to conditions like metabolic syndrome and type 2 diabetes.
The reasons are likely multifaceted. Chronic stress can disrupt hormones, such as cortisol, which in turn influences metabolism. PTSD symptoms may also make it harder to stay active or maintain a regular routine, which can loop back into worsening symptoms. It’s a cycle worth paying attention to, not to place blame, but to understand how one part of our health story may spill into another.
What This Means for Providers
One practical outcome from this review was the development of an indexing checklist for clinicians—a tool that may help them screen for PTSD alongside potential cardiovascular risk factors.
This kind of approach, which considers the whole person rather than treating mental and physical symptoms in silos, feels like a meaningful step forward in healthcare.
Final Thoughts
This review doesn’t claim PTSD causes cardiovascular disease—but it does suggest we shouldn’t ignore how they often show up together. Mental health can influence physical health in ways we’re still working to understand, and the overlap between PTSD and cardiovascular risk is an area that deserves more attention.
If you or someone you care about is living with symptoms of PTSD, know that you’re not alone. Reach out to a provider, explore your options, and remember that healing involves both the mind and the body.
