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ABSTRACT
Background: Women have twice the lifetime prevalence of posttraumatic stress disorder (PTSD) relative to men, and PTSD is a known risk factor for cardiovascular disease (CVD). Two sex hormones – estradiol and progesterone – have been found to impact both PTSD and CVD symptomatology, but the way in which sex hormones influence cardiovascular physiology among individuals with PTSD is not well understood.
Objective: This study sought to clarify the association between sex hormones, PTSD, and CVD among trauma-exposed women.
Method: Sixty-six trauma-exposed women (M age = 31.45, SD = 8.92) completed a clinical interview for PTSD and self-reported CVD symptoms; estradiol and progesterone were assayed from blood samples. The association between each sex hormone and CVD symptoms was analyzed, controlling for age, systolic blood pressure (BP), and diastolic BP.
Results: Neither estradiol nor the PTSD-by-estradiol interaction was significantly associated with CVD symptoms. Higher progesterone and, relatedly, progesterone-to-estradiol ratio (PE ratio) were each significantly associated with greater CVD symptom severity, but only for individuals with lower relative PTSD severity.
Conclusions: The findings indicate that PTSD moderates the relationship between progesterone and CVD symptoms, and further research is warranted to reconcile findings in existing literature regarding the direction of and mechanisms behind this relationship.
HIGHLIGHTS
Posttraumatic stress disorder (PTSD) is a risk factor for cardiovascular disease (CVD) and sex hormones have been implicated in their link.
The current study examined associations between sex hormones, PTSD, and CVD symptoms among 66 trauma-exposed women.
Estradiol was not significantly associated with CVD symptoms, but higher progesterone was significantly associated with greater CVD symptom severity, but only for individuals with lower relative PTSD severity.
Antecedentes: Las mujeres tienen una prevalencia del doble de trastorno de estrés postraumático (TEPT) a lo largo de la vida en comparación con los hombres, y el TEPT es un factor de riesgo conocido para la enfermedad cardiovascular (ECV). Se ha encontrado que dos hormonas sexuales, el estradiol y la progesterona, influyen tanto en el TEPT como en la sintomatología de la ECV, pero no se comprende bien la forma en que las hormonas sexuales influyen en la fisiología cardiovascular entre las personas con TEPT.
Objetivos: Este estudio buscó aclarar la asociación entre hormonas sexuales, TEPT y ECV en mujeres expuestas a traumas.
Método: Sesenta y seis mujeres expuestas a traumas (Edad media = 31.45, DE = 8.92) completaron una entrevista clínica para el TEPT y síntomas de ECV autoinformados; se analizaron estradiol y progesterona a partir de muestras de sangre. Se analizó la asociación entre cada hormona sexual y los síntomas de ECV, controlando por edad, presión arterial sistólica (PAS) y presión arterial diastólica (PAD).
Resultados: Ni el estradiol ni la interacción TEPT- estradiol se asociaron significativamente con los síntomas de ECV. Niveles más altos de progesterona y, relacionado con ello, la proporción progesterona-estradiol (PE ratio) se asociaron significativamente con una mayor gravedad de los síntomas de ECV, pero solo para individuos con una gravedad relativa más baja de TEPT.
Conclusiones: Los hallazgos indican que el TEPT modera la relación entre la progesterona y los síntomas de ECV, y se justifica una investigación adicional para reconciliar los hallazgos en la literatura existente sobre la dirección y los mecanismos detrás de esta relación.
PALABRAS CLAVE:
Data availability statement
The data that support the findings of this study are available from the corresponding author, [AVS], upon reasonable request.
Disclosure statement
No potential conflict of interest was reported by the author(s).