Grief-enhanced Trauma-informed Care process(GTC)Grief-enhanced Trauma-informed Care process(GTC)

 

Other Markers For Traumatic Stress And Grief- Vascular Markers

Traumatic stress and grief are not only psychological phenomena but also involve profound

physiological changes, particularly within the cardiovascular and vascular systems.

Dysregulation of vascular markers is a key aspect of the psychophysiological response, driven by

the interaction between the nervous, endocrine, and immune systems.

Main Key Points

Vascular and Endocrine System:

Chronic stress hormones like cortisol and adrenaline harm blood vessels, raise blood pressure, and increase inflammation. Over time, this leads to higher risks of heart disease and other cardiovascular problems.

Stress and Autonomic Imbalance:

PTSD disrupts the body’s stress-regulating systems, contributing to irregular heart rhythms and reduced cardiovascular resilience.

Immune and Metabolic Impacts:

PTSD can weaken the immune system and make it more vulnerable. It also increases the risk of insulin resistance, type 2 diabetes, and weight gain.

Sleep and Health:

Sleep problems worsen physical health by contributing to high blood pressure, poor blood sugar regulation, and fatigue, which hinders healthy lifestyle choices.

Behavioral Risks:

Unhealthy coping mechanisms like smoking, alcohol use, and physical inactivity compound cardiovascular risks.

PTSD and chronic stress significantly impact overall health, with long-term effects that extend far beyond emotional well-being. Physically, PTSD activates the body’s “fight or flight” response, leading to the release of stress hormones like adrenaline and cortisol. While these hormones are essential for short-term survival, their chronic elevation due to PTSD creates harmful effects over time. These include persistent high blood pressure, increased inflammation, and impaired function of the blood vessels, all of which heighten the risk of developing cardiovascular diseases like heart attacks, strokes, and heart failure.

PTSD also affects the autonomic nervous system, disrupting the balance between the systems that regulate stress and relaxation. This imbalance contributes to issues such as irregular heartbeats, poor blood flow, and reduced resilience of the cardiovascular system. The physical effects of PTSD go beyond the nervous and cardiovascular systems.

Chronic stress also impairs the immune system, making the body more vulnerable to infections and chronic inflammatory conditions. It also affects metabolic health, increasing the likelihood of insulin resistance, type 2 diabetes, and weight gain, which is a known risk factor for heart disease. Sleep disruptions, common in individuals with PTSD, exacerbate these physical issues by promoting hypertension, poor blood sugar control, and fatigue, which can interfere with healthy lifestyle habits.

Behavioral factors tied to PTSD further amplify its physical impact. People with PTSD may turn to smoking, alcohol, or unhealthy eating as coping mechanisms, increasing cardiovascular risks. Physical inactivity, often linked to avoidance symptoms or depression associated with PTSD, can weaken the heart and blood vessels, compounding the risks…

1. Endothelial Dysfunction

The endothelium, the inner lining of blood vessels, plays a central role in neurovascular health by regulating blood flow, coagulation, and inflammation.

  • Nitric Oxide (NO)
    • Nitric Oxide is a vasodilator critical for maintaining vascular tone and its impairment is observed in traumatic stress, and is associated with poor clinical outcome.

2. Inflammatory Vascular Markers

Inflammation is a hallmark of traumatic stress and grief, promoting vascular dysfunction.

  • C-reactive Protein (CRP)
    • CRP is a systemic inflammatory marker that reflects endothelial inflammation and vascular injury, and is increased in chronic stress and grief, and associated with poor clinical outcome.
  • Interleukin-6 (IL-6)
    • IL-6 is a pro-inflammatory cytokine that promotes CRP production and vascular inflammation, and is increased in traumatic stress and grief with increase vulnerability to coronary artery.

3. Hemodynamic Markers

Traumatic stress and grief disrupt hemodynamics, altering blood flow patterns.

  • Heart Rate Variability (HRV)
    • HRV reflects the balance between sympathetic and parasympathetic inputs to the body-mind and heart, and reduced HRV is a common feature in stress-related vascular dysregulation, and is associated with poor clinical outcome.

4. Vascular Reactivity

Vascular reactivity measures how blood vessels respond to physiological and psychological stress at the reversible stages of traumatic stress related neurovascular inflammation.

  • Reactive Hyperemia Index (RHI)
    • RHI Assesses endothelial function by measuring vasodilation in response to shear stress, and its impairment in traumatic stress disorder is associated with increased risk of inflammation, cardiovascular mortality. The preserved RHI or its improvement in response to treatment is associated with favorable clinical outcome.

References

1. Mehta, P. K., et al. (2021). Vascular dysfunction in chronic stress. Circulation Research.

2. Broadley, A. J., et al. (2005). Nitric oxide and stress-induced endothelial dysfunction. Clinical Science.

3. Spitzer, C., et al. (2022). CRP and grief: Implications for vascular health. Journal of Psychosomatic Research.

4. Barton, D. A., et al. (2018). IL-6 in traumatic stress and grief. Psychoneuroendocrinology.

5. Streider, R., et al. (2019). BPV during grief and cardiovascular events. Hypertension Journal.

6. Buckley, T., et al. (2014). Platelet activation in bereavement. Heart Journal.

7. Grenon, S. M., et al. (2016). Endothelial dysfunction in PTSD. Vascular Medicine.