Individuals with Post-traumatic Stress Disorder (PTSD) have Increased Beat-to-Beat Blood Pressure Variability

Individuals with post-traumatic stress disorder (PTSD) are at elevated risk for cardiovascular disease (CVD). Emerging research suggests that increased blood pressure variability (BPV) reflects abnormalities in autonomic regulation and may be an early indicator of future CVD risk. PTSD is associated with autonomic dysregulation that is related to PTSD symptoms and is associated with increased risk of CVD; however, BPV in PTSD remains unexplored. We hypothesized that individuals with PTSD would exhibit greater short-term BPV compared to controls and that BPV would correlate with psychological symptoms. Fifty-nine participants (PTSD: n = 38; controls: n = 21) completed beat-to-beat blood pressure recordings via finger photoplethysmography for 5-10 minutes. BPV indices included standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) for systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP). PTSD symptoms were assessed via the PTSD checklist fifth edition (PCL-5). Anxiety symptoms were assessed via the State-Trait Anxiety Inventory (STAI) and depression symptoms were assessed via Beck's Depression Inventory (BDI). Compared to controls, the PTSD group had significantly higher SBP-SD (4.3 ± 1.7 vs. 3.3 ± 1.3 mmHg, p = 0.021), SBP-CV (3.7 ± 1.6 vs. 2.7 ± 1.0 mmHg, p = 0.005), and DBP-CV (4.6 ± 1.4 vs. 3.9 ± 1.4 mmHg, p = 0.045). No group differences were found in ARV measures or cardiac baroreflex sensitivity. BPV was not significantly correlated with PTSD, anxiety, or depression symptoms. In conclusion, individuals with PTSD exhibited greater BPV, but psychological symptoms were not associated with BPV indices.