A new study finds that post-traumatic stress disorder (PTSD) may increase the long-term risk for stroke and heart attack among many of those who helped clear debris after the World Trade Center attack in 2001.

The new report is the first to come from World Trade Center-Heart, a study investigating the link between the September 11th attack in New York and the development of cardiovascular health issues among blue-collar clean-up crews.

The study involved 6,841 non-firefighter workers and untrained volunteers (82.8 percent men, average age 51), including staff from the medical examiner’s office who processed human remains as well as the Port-Authority Trans-Hudson Corporation and others who participated in the cleanup, recovery, service restoration and other tasks in the months following the attack.

The researchers investigated the impact of PTSD on heart disease in people 11 to 15 years after the occurrence of the traumatic event. The study provided four years’ worth of data on those subjects.

The findings show that prevalence of PTSD was about 20 percent among men and 26 percent among women — at least twice that of the general population. Incidence of heart attack or stroke was 2.35 times greater for those with PTSD.

Researchers collected the following information from the participants:

  • baseline mental health;
  • blood pressure and cholesterol;
  • whether participants began working on or after September 11, 2001;
  • the proximity of their location to the site;
  • whether they worked directly within the dust cloud and whether they wore a protective mask.

Although blood cholesterol, blood pressure and body mass are recognized as risk factors of heart disease, these were not associated with heart attack or stroke in the study participants. Similarly, exposure to the dust was not independently associated with heart attack and stroke in this group.

Despite the large sample size, the study may not provide an accurate cross-sectional representation for the approximately 90,000 first-responders who helped following the World Trade Center attack.

The findings suggest that untrained first responders who engage in activities surrounding the aftermath of disasters are more likely to struggle with mental health issues following their work than first responders who have received training.

“PTSD’s association with heart attack and stroke should be taken into consideration when untrained first responders are sent to respond to catastrophes of different types,” said Alfredo Morabia, M.D., Ph.D., study senior author and professor of epidemiology at City University of New York and Columbia University Mailman School of Public Health.

“Heart attack and stroke should be considered a related disease in World Trade Center first responders and it should be incorporated along with their benefits and care.”

PTSD is a mental health condition characterized by the re-experiencing of traumatic events, avoidance of triggers, hyperarousal and negative mood.

The study was published in the journal Circulation: Cardiovascular Quality and Outcomes.

Source: American Heart Association