Resting Blood Pressure Variability in Premenopausal Women with PTSD: the Influence of Depression

Although the adverse cardiovascular consequences of hypertension largely depend on absolute blood pressure (BP), recent studies have shown that increased blood pressure variability (BPV) is a powerful predictor of cardiovascular events and confers strong prognostic value beyond the absolute BP level. Our study aimed to investigate indices of BPV in otherwise healthy young women with post-traumatic stress disorder (PTSD), an emerging risk factor for cardiovascular disease. We hypothesized that premenopausal women with PTSD (PTSD+) will present with augmented beat-to-beat BPV compared to trauma-exposed women without PTSD (PTSD-). We recruited twenty-two PTSD+ (28 ± 6 years) and twenty-two PTSD- (25 ± 6 years) women, and collected mental health questionnaires and baseline hemodynamics data. Resting beat-to-beat BP (finger plethysmography) and heart rate (electrocardiography) were continuously measured for 10 min, and we calculated standard deviation and average real variability as BPV indices. PTSD symptom severity was assessed using the PTSD Checklist for DSM-5 (PCL-5) and depression symptom severity using the Beck’s Depression Inventory (BDI). We used an unpaired t-test to compare questionnaire and hemodynamic data between the two groups. PTSD+ women had higher body mass index (29.09 ± 6.45 vs 24.74 ± 3.63 kg/m 2 , p=0.008) and higher BDI score (23.32 ± 11.40 vs 14.73 ± 12.47 a.u., p=0.022) compared to the PTSD- women. As expected, PCL-5 score was higher in PTSD+ compared to PTSD- (39.95 ± 14.57 vs 25.14 ± 15.55 a.u., p=0.002). To test our hypothesis, we ran a univariate analysis of covariance exploring the differences in systolic and diastolic BPV between the two groups of women, while controlling for body mass index and BDI score. Our analysis of covariance revealed that systolic BPV was lower [F(1,40) = 2.92, p = 0.048] in PTSD- compared to PTSD+ (1.50 ± 0.34 mmHg vs 1.60 ± 0.34 mmHg), when controlling for body mass index and BDI. However, diastolic BPV was comparable between the groups. Overall, this study suggests that depression, a condition that is highly comorbid with PTSD, may influence systolic BPV in premenopausal women with PTSD. Future research should explore depression as a potential moderator of dynamic fluctuations of BP over time in women diagnosed with PTSD. This study was supported by grants K01HL161027, UMN CTSI UL1TR002494, and U54AT012307. This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.