Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV
Background: HIV induced endothelial dysfunction (ED) contributes to cardiovascular disease (CVD) in women with HIV (WWH). Although psychosocial stress has been implicated in the development of CVD in HIV, its impact on ED in WWH remains unknown. Objectives: The authors hypothesized that posttraumati...
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Elsevier
2025-02-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X24008536 |
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| author | Nishant Vatsa, MD Alireza Rahbar, MD Tanveer Kauser, MPH Ariel Kirksey, BS Daniel A. Gold, MD Vardhmaan Jain, MD Matthew E. Gold, MD Heqiong Wang, MD, MPH Christina Mehta, PhD, MSPH Caitlin A. Moran, MD Alicia K. Smith, PhD Kimbi Hagen, EdD, Med Ighovwerha Ofotokun, MD, MSc Cecile D. Lahiri, MD, MS Laurence Sperling, MD Viola Vaccarino, MD, PhD Puja K. Mehta, MD Arshed A. Quyyumi, MD Gretchen N. Neigh, PhD Vasiliki Michopoulos, PhD |
| author_facet | Nishant Vatsa, MD Alireza Rahbar, MD Tanveer Kauser, MPH Ariel Kirksey, BS Daniel A. Gold, MD Vardhmaan Jain, MD Matthew E. Gold, MD Heqiong Wang, MD, MPH Christina Mehta, PhD, MSPH Caitlin A. Moran, MD Alicia K. Smith, PhD Kimbi Hagen, EdD, Med Ighovwerha Ofotokun, MD, MSc Cecile D. Lahiri, MD, MS Laurence Sperling, MD Viola Vaccarino, MD, PhD Puja K. Mehta, MD Arshed A. Quyyumi, MD Gretchen N. Neigh, PhD Vasiliki Michopoulos, PhD |
| author_sort | Nishant Vatsa, MD |
| collection | DOAJ |
| description | Background: HIV induced endothelial dysfunction (ED) contributes to cardiovascular disease (CVD) in women with HIV (WWH). Although psychosocial stress has been implicated in the development of CVD in HIV, its impact on ED in WWH remains unknown. Objectives: The authors hypothesized that posttraumatic stress disorder (PTSD) and HIV interact to contribute to ED in WWH. Methods: We enrolled 87 women from the Women’s Interagency HIV Study in Atlanta, Georgia, who reported previous trauma and completed the PTSD Checklist: Civilian Version (PCL-C), which assesses PTSD symptom severity (PCL-C score) and PTSD status (PCL-C >44). Brachial artery flow-mediated dilation (FMD) was measured to assess endothelial function. The impact of PTSD, HIV, and their interaction on endothelial function was evaluated using linear regression models adjusted for demographics, CVD risk factors, depressive symptoms, and statin use. Results: Overall, 55 (63.2%) had HIV, 24 (27.5%) had PTSD, and 13 (14.9%) had both. Those with PTSD were more likely to smoke (18 [75%] vs 28 [44.4%], P = 0.02) and have depressive symptoms (14 [58.3%] vs 18 [28.6%], P = 0.02) than those without PTSD. In adjusted models, the HIV-PTSD (severity and status) interaction effect on FMD was significant (P = 0.01). Both PTSD severity (β per 10-point increase: −0.72% [95% CI: −1.22 to −0.21], P = 0.01) and PTSD status (β: −2.51% [95% CI: −4.21 to −0.77], P = 0.01) were independently associated with lower FMD in WWH but not in those without HIV. Conclusions: PTSD is independently associated with ED in WWH. Whether treatment for PTSD improves ED and CVD in WWH needs further study. |
| format | Article |
| id | doaj-art-aaab21d9df944110b3258ec54c2e7800 |
| institution | Kabale University |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Advances |
| spelling | doaj-art-aaab21d9df944110b3258ec54c2e78002025-01-21T04:13:25ZengElsevierJACC: Advances2772-963X2025-02-0142101572Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIVNishant Vatsa, MD0Alireza Rahbar, MD1Tanveer Kauser, MPH2Ariel Kirksey, BS3Daniel A. Gold, MD4Vardhmaan Jain, MD5Matthew E. Gold, MD6Heqiong Wang, MD, MPH7Christina Mehta, PhD, MSPH8Caitlin A. Moran, MD9Alicia K. Smith, PhD10Kimbi Hagen, EdD, Med11Ighovwerha Ofotokun, MD, MSc12Cecile D. Lahiri, MD, MS13Laurence Sperling, MD14Viola Vaccarino, MD, PhD15Puja K. Mehta, MD16Arshed A. Quyyumi, MD17Gretchen N. Neigh, PhD18Vasiliki Michopoulos, PhD19Division of Cardiology, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USADivision of Infectious Diseases, Emory University, Atlanta, Georgia, USADivision of Infectious Diseases, Emory University, Atlanta, Georgia, USADivision of Infectious Diseases, Emory University, Atlanta, Georgia, USADepartment of Gynecology and Obstetrics, Emory University, Atlanta, Georgia, USA; Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USADepartment of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USADivision of Infectious Diseases, Emory University, Atlanta, Georgia, USADivision of Infectious Diseases, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USADivision of Cardiology, Emory University, Atlanta, Georgia, USADepartment of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, Virginia, USADepartment of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA; Address for correspondence: Dr Vasiliki Michopoulos, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Emory National Primate Research Center, Emory University, Atlanta, Georgia 30322, USA.Background: HIV induced endothelial dysfunction (ED) contributes to cardiovascular disease (CVD) in women with HIV (WWH). Although psychosocial stress has been implicated in the development of CVD in HIV, its impact on ED in WWH remains unknown. Objectives: The authors hypothesized that posttraumatic stress disorder (PTSD) and HIV interact to contribute to ED in WWH. Methods: We enrolled 87 women from the Women’s Interagency HIV Study in Atlanta, Georgia, who reported previous trauma and completed the PTSD Checklist: Civilian Version (PCL-C), which assesses PTSD symptom severity (PCL-C score) and PTSD status (PCL-C >44). Brachial artery flow-mediated dilation (FMD) was measured to assess endothelial function. The impact of PTSD, HIV, and their interaction on endothelial function was evaluated using linear regression models adjusted for demographics, CVD risk factors, depressive symptoms, and statin use. Results: Overall, 55 (63.2%) had HIV, 24 (27.5%) had PTSD, and 13 (14.9%) had both. Those with PTSD were more likely to smoke (18 [75%] vs 28 [44.4%], P = 0.02) and have depressive symptoms (14 [58.3%] vs 18 [28.6%], P = 0.02) than those without PTSD. In adjusted models, the HIV-PTSD (severity and status) interaction effect on FMD was significant (P = 0.01). Both PTSD severity (β per 10-point increase: −0.72% [95% CI: −1.22 to −0.21], P = 0.01) and PTSD status (β: −2.51% [95% CI: −4.21 to −0.77], P = 0.01) were independently associated with lower FMD in WWH but not in those without HIV. Conclusions: PTSD is independently associated with ED in WWH. Whether treatment for PTSD improves ED and CVD in WWH needs further study.http://www.sciencedirect.com/science/article/pii/S2772963X24008536endothelial functionhuman immunodeficiency virusposttraumatic stress disorderwomen |
| spellingShingle | Nishant Vatsa, MD Alireza Rahbar, MD Tanveer Kauser, MPH Ariel Kirksey, BS Daniel A. Gold, MD Vardhmaan Jain, MD Matthew E. Gold, MD Heqiong Wang, MD, MPH Christina Mehta, PhD, MSPH Caitlin A. Moran, MD Alicia K. Smith, PhD Kimbi Hagen, EdD, Med Ighovwerha Ofotokun, MD, MSc Cecile D. Lahiri, MD, MS Laurence Sperling, MD Viola Vaccarino, MD, PhD Puja K. Mehta, MD Arshed A. Quyyumi, MD Gretchen N. Neigh, PhD Vasiliki Michopoulos, PhD Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV JACC: Advances endothelial function human immunodeficiency virus posttraumatic stress disorder women |
| title | Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV |
| title_full | Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV |
| title_fullStr | Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV |
| title_full_unstemmed | Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV |
| title_short | Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV |
| title_sort | posttraumatic stress disorder is associated with endothelial dysfunction in women with hiv |
| topic | endothelial function human immunodeficiency virus posttraumatic stress disorder women |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X24008536 |
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