Women with elevated symptoms of post-traumatic stress disorder (PTSD) consistent with the clinical threshold for the disorder had 60% higher rates of having a heart attack or stroke compared with women who never experienced trauma, according to scientists at Columbia University’s Mailman School of Public Health and the Harvard T.H. Chan School of Public Health. Results appear in Circulation, the journal of the American Heart Association.

In a survey of nearly 50,000 younger and middle-aged women in the Nurses’ Health Study II, 80% reported experiencing a traumatic event in their lives. More than half of this group (58%) reported no symptoms of PTSD. Those reporting symptoms of PTSD were split evenly between those with one to three symptoms and those with four or more symptoms, a commonly used clinical cut-off for PTSD.

Trauma exposure alone—that is, reporting trauma but no symptoms of PTSD—also increased risk for heart attack and stroke by nearly 50%. However, cardiovascular risk in women who experienced trauma with one to three symptoms of PTSD was unchanged.

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