LOS ANGELES – The use of selective serotonin reuptake inhibitors in treating combat posttraumatic stress disorder in middle-aged veterans was associated with sharply reduced cardiovascular mortality in a large observational study, according to Dr. Naser Ahmadi of the VA Greater Los Angeles Healthcare System.
Treatment with a selective serotonin reuptake inhibitor also appeared to protect against development of metabolic syndrome in this patient population, he added at the annual scientific sessions of the American Heart Association.
Dr. Ahmadi reported on 1,142 veterans with combat-induced PTSD, 433 of whom had received SSRI therapy for the disorder. Fifty-three percent of subjects met criteria for metabolic syndrome.
During a median 5 years of follow-up through the Veterans Affairs system’s electronic medical record system, the cardiovascular mortality was 21% in patients with PTSD and metabolic syndrome, compared with 14% in those without metabolic syndrome. Thus, comorbid metabolic syndrome in patients with combat PTSD was associated with a 68% increase in the risk of cardiovascular mortality.
The prevalence of metabolic syndrome was 32% among SSRI recipients, compared with 45% in those whose PTSD was not treated SSRIs. After adjusting for age, gender, and conventional cardiovascular risk factors in a multivariate analysis, the relative risk of metabolic syndrome in patients with PTSD was 71% lower with SSRI therapy than without it.
Moreover, the adjusted risk of cardiovascular mortality over the course of a median 5 years of follow-up in this hypothesis-generating observational study was 36% lower in SSRI-treated patients with PTSD and metabolic syndrome than in those not on an SSRI, and 64% lower in SSRI-treated patients with PTSD without metabolic syndrome.
This study received funding from the American Heart Association. Dr. Ahmadi reported having no financial conflicts.