This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Mellman, T. A. Articles by Randall, O. S. Search for Related Content PubMed PubMed Citation Articles by Mellman, T. A. Articles by Randall, O. S. Related Collections PTSD Blood Pressure

Posttraumatic Stress Disorder and Nocturnal Blood Pressure Dipping in Young Adult African Americans

From the Department of Psychiatry and Behavioral Sciences (T.A.M., D.D.B., E.S.J., M.M.S.H.) and the Department of Medicine (O.S.R.), Division of Cardiology, Howard University, Washington, DC.

Address correspondence and reprint requests to Thomas A. Mellman, Department of Psychiatry, Howard University College of Medicine, 2041 Georgia Ave, NW, Washington, DC 20059. E-mail: TMellman{at}Howard.edu

Objective: To evaluate the relationship between posttraumatic stress disorder (PTSD) and nocturnal blood pressure (BP) dipping in young adult African Americans (AAs). PTSD is associated with physical illnesses including cardiovascular conditions. Sleep disturbances related to heightened arousal likely contribute to physical health risk; however, this possibility has not been studied. The studies that have found a relationship between PTSD and hypertension (HTN) have substantial representation of AAs. AAs have elevated rates of HTN and are more likely to exhibit an absence of the normal "dip" of BP at night. Nocturnal BP "nondipping" is an established risk factor for HTN and its cardiovascular complications. Nocturnal BP nondipping and sleep disturbances of PTSD have both been linked to sympathetic nervous system function.

Methods: Thirty healthy young adult AAs (60% female; mean age = 20.0 years; 17 with lifetime full or subthreshold PTSD, 4 with current symptoms) received 24-hour BP and actigraphy monitoring, filled out sleep diaries, and had structured clinical assessment of PTSD.

Results: There were significant associations of lifetime full and subthreshold PTSD and BP nondipping, and the degree of nocturnal dipping correlated with lifetime and current PTSD severity.

Conclusion: Elevated nocturnal BP may be a link between PTSD and cardiovascular morbidity in AAs that can be targeted in prevention.

Key Words: posttraumatic stress disorder • hypertension • blood pressure nondipping • African American

Abbreviations: PTSD = posttraumatic stress disorder; AA = African American; HTN = hypertension; BP = blood pressure; SNS = sympathetic nervous system; MAP = mean arterial pressure; CAPS = Clinician Administered PTSD Scale.