Posttraumatic stress disorder (PTSD) is linked to both altered physiological functioning and poorer cardiovascular health outcomes, including an increased risk for cardiovascular disease and cardiovascular‐related mortality. An important question is whether interventions for PTSD might ameliorate the risk for poorer health by improving cardiovascular physiological intermediaries. To begin to characterize the literature addressing this question, we conducted a systematic review of empirical studies examining the impact of PTSD interventions on cardiovascular physiological intermediaries, including blood pressure (BP), heart rate (HR), cardiac impedance, and subclinical atherosclerosis. Outcomes included both tonic (i.e., resting) cardiovascular functioning and cardiovascular reactivity (CVR). A total of 44 studies met the inclusion criteria. There was mixed evidence regarding whether PTSD treatment improved tonic cardiovascular functioning. There was stronger evidence that PTSD treatments reduced CVR to trauma‐related stressors, particularly for higher‐quality studies of cognitive behavioral interventions. No studies examined cardiac impedance or subclinical atherosclerosis. The studies had a high degree of heterogeneity in the populations sampled and interventions tested. Moreover, they generally included small sample sizes and lacked control conditions. Interventions for PTSD may improve cardiovascular physiological outcomes, particularly CVR to trauma cues, although additional methodologically rigorous studies are needed. We outline changes to future research that would improve the literature regarding this important question, including the more frequent use of control groups and larger sample sizes.

中文翻译：

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创伤后应激障碍治疗对心血管生理学的影响：系统回顾和未来研究议程

创伤后应激障碍 (PTSD) 与生理功能改变和心血管健康结果较差有关，包括心血管疾病和心血管相关死亡率的风险增加。一个重要的问题是，对 PTSD 的干预是否可以通过改善心血管生理中介来改善健康状况不佳的风险。为了开始描述解决这个问题的文献，我们对实证研究进行了系统回顾，研究了 PTSD 干预对心血管生理中介的影响，包括血压 (BP)、心率 (HR)、心脏阻抗和亚临床动脉粥样硬化。结果包括强直（即静息）心血管功能和心血管反应性（CVR）。共有 44 项研究符合纳入标准。关于 PTSD 治疗是否能改善强直性心血管功能的证据不一。有更强有力的证据表明，PTSD 治疗降低了创伤相关压力源的 CVR，特别是对于认知行为干预的高质量研究。没有研究检查心脏阻抗或亚临床动脉粥样硬化。这些研究在抽样的人群和测试的干预措施中具有高度的异质性。此外，它们通常包括小样本量并且缺乏控制条件。对 PTSD 的干预可能会改善心血管生理结果，尤其是对创伤线索的 CVR，尽管需要额外的方法学上严格的研究。我们概述了未来研究的变化，这些变化将改善关于这个重要问题的文献，