Examining the Link Between PTSD and Stroke in the Young Adult Population

By Katy Mena-Berkley
Wednesday, March 11, 2020

Ischemic stroke and transient ischemic attack (TIA) have grown more prevalent in young and middle-aged adults during the past decade. According to research led by the University of North Carolina School of Medicine, post-traumatic stress disorder may be to blame.

Typically thought of as an event mostly occurring the senior population, stroke incidence is increasing among individuals in the prime of life. Today, 10% to 14% of strokes occur in adults ages 18 to 45, and a team of researchers has spent the past 13 years trying to determine whether people in this age group have the same risk factors for stroke as older individuals. Specifically, author Lindsey Rosman, PhD, Assistant Professor of Medicine, Division of Cardiology, UNC School of Medicine, and her team were interested in understanding whether increased exposure to extremely stressful or traumatic life events, such as gun violence, military combat or natural disaster, had a profound impact on risk of stroke in the younger population.

“This trend is very concerning given the devastating impact stroke has on young patients and their families, many of whom struggle to cope with long-term disability, depression and economic loss during their most productive years,” Dr. Rosman says. “While traditional risk factors for stroke like hypertension may account for some of this increase, there are other factors that we need to pay attention to that may be uniquely impacting young people.”

“Because PTSD is a potentially treatable psychological condition, understanding the relationship between [PTSD and stroke] may have important implications for improving stroke prevention and treatment in young and middle-aged adults.”
— Lindsey Rosman, PhD, Assistant Professor of Medicine, Division of Cardiology, UNC School of MedicinE

The Study

To conduct their research, the team examined a national sample of roughly 1.1 million young and middle-aged members of the United States military. During the 13-year study period, 28% of the veterans were diagnosed with PTSD. The study team controlled for proven risk factors of stroke, such as health behaviors and comorbid conditions, and found that individuals with PTSD were 61% more likely to experience TIA and 36% more likely to experience ischemic stroke than people without PTSD.

“To the best of our knowledge, this study is the first to demonstrate a link between trauma-induced stress disorders and risk of TIA and ischemic stroke in young and middle-aged adults who are increasingly at risk for both conditions yet remain largely underrepresented in epidemiological studies and clinical trials,” Dr. Rosman says. “Our findings raise important questions about whether early recognition and successful treatment of PTSD can prevent or mitigate the likelihood of developing stroke among those exposed to violence, severe adversity and trauma ... If so, addressing mental health issues, including PTSD, may be an important part of a broader public health initiative to reduce the growing burden of stroke in young people.”