High blood pressure, high cholesterol, diabetes, stress and smoking put us all at risk for heart disease. To date, however, nothing has explained why people with PTSD (post traumatic stress disorder) are at higher risk.

We may now know.

A new study from the American Heart Association finds that the disorder may decrease the ability of blood vessels to dilate when needed. Blood vessels that do not dilate significantly raise the risk of a heart attack or stroke. And the impact of emotional stress puts chronic stress on blood vessels.

“Veterans represent a unique demographic of people who have endured trauma. Their combat tours lasted on average 12-months, which means they experienced stress for a very long period of time and without rest,” said Dr. Vincent Passarelli, a clinical psychologist based in New York who has worked extensively with veterans and various trauma survivors.

He told LifeZette, “Serving in a combat zone will keep your body in a state of heightened physical and mental arousal as a way to protect yourself and others whenever needed. Given that many veterans who suffer from PTSD are hesitant to seek treatment, their symptoms persist.”

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Dr. Passarelli said the findings of the study are important and consistent with what is known about the long-term effects of prolonged stress. The issue starts in the brain and circulates to other areas of the body — such as the blood vessels.

[lz_bulleted_list title=”PTSD Facts” source=”http://www.ptsdunited.org”]24.4 million Americans affected|Women twice as likely to suffer|Responsible for nearly half of all outpatient mental health visits|$42.3 billion annual cost[/lz_bulleted_list]

“The ongoing symptomatology of PTSD creates physiological changes that are disruptive to body in a systemic way. Although this can be different for each person, prolonged stress is commonly correlated with heart disease, high blood pressure, and hormonal imbalances — which are, in turn, further related to depression and other mental health disorders that take a toll on our body. It becomes a progressive and negative cycle.”

As a result of the AHA study, the organization encourages better ways of managing PTSD, traumatic experiences and other types of stress  that can help reduce the negative impact of chronic stress on blood vessels. Therapy is one recommendation; but exercise and diet are also heavily recommended, as is having a strong social support system.

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“The brain is always going to want to return to the ‘scene of the crime’ or to traumatic emotions, to try to resolve them. In reliving trauma, the brain hopes to change the conditions,” said Dr. Claudia Luiz, a psychoanalyst with Harvard Medical School and the author of “Where’s My Sanity? Stories That Help.” Dr. Luiz is looking at what can be done to derail PTSD in those affected.

Veterans, of course, are not the only ones at risk.

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“Civilian trauma events are different from that of a veterans,” said Dr. Passarelli. “People who are not veterans and have endured a traumatic event need to be aware of these study results as well. The effects of trauma over time can create physiological, behavioral and/or emotional disruptions.”

Getting help is tremendously important. The problem, experts say, is that many times there is guilt associated with the traumatic experience — and it prevents patients from seeking the help they need.

“Depending on what the trauma arouses in the personality — guilt, terror, anxiety, shame — different treatments can be effective in creating new brain circuitry,” said Dr. Luiz.

Ultimately, experts agree this is one step further to learning how the brain functions and how we can help people get the help they need sooner.

“The more we know about the tricks our brain can play on us, the more we can understand how not to buy in to the terrible fear, terror and anxiety associated with PTSD,” said Luiz.

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