Readmission Up With PTSD in Black American Veterans With Stroke

(HealthDay News) — For Black American veterans with stroke, preexisting posttraumatic stress disorder (PTSD) is associated with an increased risk for hospital readmission, according to a study published online March 14 in Stroke.

Chen Lin, M.D., from the University of Alabama at Birmingham, and colleagues examined whether PTSD is associated with the risk for hospital readmission after stroke in an analytical sample including all veterans receiving care in the Veterans Health Administration who were identified as having a new stroke.

The final cohort included 93,651 patients with an inpatient stroke diagnosis and no prior codes for stroke from 1999; patients were followed through Aug. 6, 2022. The researchers found that 13.8 percent of the patients had comorbid PTSD. Eighteen percent of patients from the final cohort with stroke were readmitted. There was an interaction between Black American veterans and PTSD, with a hazard ratio of 1.09 in the fully adjusted model for readmission. PTSD had a significant hazard ratio of 1.10 for Black Americans, but not White, veterans in a stratified model.

“This study highlights the need for further investigation into this high-risk group including the development of postdischarge transitional care plans to reduce readmissions after stroke,” the authors write.

One author disclosed ties to the pharmaceutical industry.

How PTSD and strokes are linked

Post-traumatic stress disorder (PTSD) and stroke are two distinct medical conditions, but there can be indirect links between them, primarily through the impact of stress on cardiovascular health.

PTSD is a psychiatric condition triggered by a traumatic event. It often involves persistent stress, anxiety, and intrusive memories related to trauma. Chronic stress, as experienced in PTSD, can have profound effects on cardiovascular health. Stress hormones such as cortisol and adrenaline can lead to increased blood pressure, inflammation, and changes in blood clotting, all of which are risk factors for stroke.

People with PTSD may engage in behaviors that further increase their risk of stroke, such as smoking, excessive alcohol consumption, poor diet, and lack of physical activity. These behaviors can contribute to the development of conditions like hypertension, diabetes, and obesity, all of which are risk factors for stroke.

People with PTSD may be less likely to seek medical care or adhere to prescribed treatments for other health conditions, including those that increase stroke risk. This can result in untreated or poorly managed risk factors, further increasing the likelihood of stroke.

Studies have also shown that PTSD is associated with alterations in brain regions involved in stress regulation, emotion processing, and cardiovascular control. These changes could potentially influence the risk of stroke, although the exact mechanisms are not fully understood.

Not everyone with PTSD will experience a stroke, and many factors contribute to the development of both conditions. However, managing stress, seeking appropriate mental health support, and addressing cardiovascular risk factors are essential for overall health and well-being, particularly for individuals with PTSD.

Black Veterans and PTSD

Veterans are at an increased risk of developing post-traumatic stress disorder (PTSD) due to their exposure to traumatic events during military service. They often experience intense and life-threatening situations during combat, including witnessing injury and death, engaging in combat themselves, and facing the constant threat of harm. These experiences can lead to the development of PTSD symptoms. Veterans may also sustain traumatic brain injuries due to blasts, concussions, or other combat-related incidents. TBI is closely linked with PTSD, and individuals who experience both conditions may have more severe and persistent symptoms.

Studies have shown Black veterans have higher rates of PTSD than their white counterparts. These veterans may face difficulties accessing appropriate mental health care or may encounter stigma surrounding mental health issues in the military and Black culture. A lack of social support or understanding from peers and society can hinder veterans’ ability to seek help and receive treatment for PTSD.

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