POSTTRAUMATIC stress disorder (PTSD) is associated with significantly worse endothelial dysfunction (ED) in women with HIV, independent of cardiovascular disease (CVD) risk factors.
HIV contributes to endothelial dysfunction, a precursor to cardiovascular disease, in women with HIV (WWH). Psychosocial stress, such as PTSD, is also linked to cardiovascular health, but its specific effect on ED in this population had not been fully explored. This study aimed to investigate the relationship between PTSD, HIV, and endothelial dysfunction in women with HIV, using data from 87 participants of the Women’s Interagency HIV Study in Atlanta, Georgia.
Eighty-seven women who reported prior trauma were enrolled and completed the PTSD Checklist: Civilian Version (PCL-C), which measures PTSD severity and status. Brachial artery flow-mediated dilation (FMD) was used as a marker of endothelial function. Among participants, 55 (63.2%) were living with HIV, 24 (27.5%) had PTSD, and 13 (14.9%) had both. Those with PTSD were more likely to smoke (75% vs 44.4%) and experience depressive symptoms (58.3% vs 28.6%) than those without PTSD. After adjusting for demographics, cardiovascular risk factors, depressive symptoms, and statin use, both PTSD severity and status were independently linked to poorer FMD in WWH (P = 0.01). The interaction between HIV and PTSD in influencing FMD was statistically significant (P = 0.01), with a 2.51% lower FMD observed in women with both conditions.
These findings underline PTSD as a potentially modifiable risk factor for cardiovascular disease in WWH. Early screening and treatment of PTSD—through effective pharmacological and counseling interventions—could mitigate its impact on endothelial function and cardiovascular outcomes. Future research should focus on whether addressing PTSD can improve endothelial health and reduce cardiovascular risk in this population.
Katrina Thornber, EMJ
Reference
Vatsa N et al. Posttraumatic stress disorder is associated with endothelial dysfunction in women with HIV. JACC: Advances. 2025;4(2):101572.
