Mental Health
Sex Differences in Anti-hypertensive Medications and PTSD Incidence in a Trauma Cohort Sophie Selbe* Sophie Selbe Travis Evans Timothy L. Lash Henrik Toft Sørensen Jaimie Gradus Jennifer Sumner
Studies have documented protective associations between some antihypertensive (AHT) medications and the development or maintenance of posttraumatic stress disorder (PTSD), but few include samples large enough to examine multiple AHT classes or sex differences in one sample. Our study fills this gap in the literature.
Data came from a trauma cohort established from the Danish national health care and social registries from 1994 to 2016. All members of the cohort experienced one or more of the following traumatic experiences: fire/explosion, transportation accident, exposure to a toxic substance/medical complications, traumatic brain injury, assault with or without a weapon, pregnancy-related trauma, suicide death of a family member. The outcome was incident PTSD. The exposed group redeemed prescriptions for AHT medications including beta blockers, angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), and calcium channel blockers within 60 days before their traumatic event. For the unexposed group, five persons who never redeemed an AHT medication were matched to the exposed group on age, sex, trauma type, and year. We ran descriptive analyses followed by Cox proportional hazards regression adjusted for marital status, income, and Charlson Comorbidity Index score to estimate hazard ratios (HR) and 95% CIs for the associations between AHT medication class and incident PTSD.
We observed a protective effect for calcium channel blockers and the development of PTSD for both women (HR=0.79; 95% CI=0.29,2.17) and men (HR=0.49; 95% CI=0.22,1.09). A slight protective effect was observed for beta-blockers in men and women; while ACEIs showed near-null effects. ARBs however displayed a protective effect in women (HR=0.47; 95% CI=0.11,2.11), but not protective in men (HR=1.35; 95% CI=0.50,3.61).
Overall, results suggest that there are sex differences among the previously documented protective effects of AHT medications on the development of PTSD.
