A PROSPECTIVE-STUDY OF HEART-RATE RESPONSE FOLLOWING TRAUMA AND THE SUBSEQUENT DEVELOPMENT OF POSTTRAUMATIC-STRESS-DISORDER

Background: Physiological arousal during traumatic events may trigger the neurobiological processes that lead to posttraumatic stress disord er (PTSD). This study prospectively examined the relationship between heart rate and blood pressure recorded immediately following a traumat ic event and the subsequent development of PTSD. Methods: Eighty-six t rauma survivors who presentd at the emergency department of a general hospital were followed up for 4 months. Heart rate and blood pressure were recorded on arrival at the emergency department. Heart rate, anxi ety, depression, and PTSD symptoms were assessed 1 week, 1 month, and 4 months later. The clinician-administered PTSD scale defined PTSD sta tus at 4 months. Results: Twenty subjects (23%) met PTSD diagnostic cr iteria at the 4-month assessment (PTSD group), and 66 (77%) did not (n on-PTSD group). Subjects who developed PTSD had higher heart rates at the emergency department (95.5+/-13.9 vs 83.3+/-10.9 beats per minute, t=4.4, P<.001) and 1 week later (77.8+/-11.9 vs 72.0+/-4.5 beats per minute, t=2.25, P<.03), but not after 1 and 4 months. The groups did n ot differ in initial blood pressure measurement. Repeated-measures ana lysis of variance (ANOVA) for heart rate showed a significant group ef fect (P<.02), time effect (P<.001), and group x time interaction (P<.0 01). The time effect and group x time interaction remained significant when adjusted for sex, age, trauma severity, immediate response, and dissociation during the traumatic event. Conclusion: Elevated heart ra te shortly after trauma is associated with the later development of PT SD.