{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:21:06Z","timestamp":1790720466294,"version":"4.1.0"},"reference-count":67,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: This meta-analysis aimed to examine the bidirectional association between PTSD and cardiovascular disease (CVD) by evaluating the following: (1) the risk of increased CVD incidence in individuals with PTSD; and (2) the prevalence of PTSD in patients with cardiovascular disease. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted of the PubMed\/Medline, Scopus, and Web of Science databases without using a temporal publication range. For the PTSD-to-CVD direction, 18 studies were combined. For the CVD-to-PTSD direction, 11 studies that ascertained the incidence or prevalence of PTSD following a CVD event were combined. Results: The findings confirm the bidirectional and clinically significant relationship between CVD and PTSD. Conclusions: These data underscore the need to integrate trauma-informed approaches into cardiovascular care and stress management into psychiatric treatment to stop this pathological cycle.<\/jats:p>","DOI":"10.3390\/jcm14227979","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T08:57:41Z","timestamp":1762851461000},"page":"7979","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Post-Traumatic Stress Disorder (PTSD) and Cardiovascular Diseases: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8790-6007","authenticated-orcid":false,"given":"Omar Anwar Saleh","family":"Al Nakhebi","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluka","family":"Albu-Kalinovic","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9396-0321","authenticated-orcid":false,"given":"Oana","family":"Neda-Stepan","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8962-0000","authenticated-orcid":false,"given":"Catalina","family":"Giurgi-Oncu","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u0103t\u0103lina-Angela","family":"Cri\u0219an","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0136-1142","authenticated-orcid":false,"given":"Virgil-Radu","family":"Enatescu","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ileana","family":"Marinescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association, DSM-5 Task Force (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5\u2122, American Psychiatric Publishing, Inc.. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s11920-019-1032-1","article-title":"PTSD as a Public Mental Health Priority","volume":"21","author":"Watson","year":"2019","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1007\/s00127-016-1208-5","article-title":"The epidemiology of DSM-5 posttraumatic stress disorder in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-III","volume":"51","author":"Goldstein","year":"2016","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1037\/pas0000642","article-title":"Latent factor structure of DSM-5 posttraumatic stress disorder: Evaluation of method variance and construct validity of novel symptom clusters","volume":"31","author":"Lee","year":"2019","journal-title":"Psychol. Assess."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S60","DOI":"10.3949\/ccjm.76.s2.12","article-title":"Is posttraumatic stress disorder related to development of heart disease? An update","volume":"76","author":"Kubzansky","year":"2009","journal-title":"Cleve. Clin. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1001\/jamacardio.2021.2530","article-title":"Posttraumatic Stress Disorder and Cardiovascular Disease: State of the Science, Knowledge Gaps, and Research Opportunities","volume":"6","author":"Cohen","year":"2021","journal-title":"JAMA Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Edmondson, D., Richardson, S., Falzon, L., Davidson, K.W., Mills, M.A., and Neria, Y. (2012). Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: A meta-analytic review. PLoS ONE, 7, Erratum in PLoS ONE 2019, 14, e0213635. https:\/\/doi.org\/10.1371\/journal.pone.0213635.","DOI":"10.1371\/journal.pone.0213635"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"102632","DOI":"10.1016\/j.cpcardiol.2024.102632","article-title":"Cardiovascular impact of post-traumatic stress disorder: A systematic review and meta-analysis","volume":"49","author":"Padhi","year":"2024","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.amjcard.2011.02.340","article-title":"Post-traumatic stress disorder, coronary atherosclerosis, and mortality","volume":"108","author":"Ahmadi","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1097\/00006842-200107000-00011","article-title":"A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder","volume":"63","author":"Buckley","year":"2001","journal-title":"Psychosom. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"R315","DOI":"10.1152\/ajpregu.00343.2014","article-title":"Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease","volume":"309","author":"Brudey","year":"2015","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.neubiorev.2011.11.009","article-title":"A meta-analysis of heart rate variability and neuroimaging studies: Implications for heart rate variability as a marker of stress and health","volume":"36","author":"Thayer","year":"2012","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1002\/da.23271","article-title":"Involvement of the brain-heart axis in the link between PTSD and cardiovascular disease","volume":"39","author":"Seligowski","year":"2022","journal-title":"Depress. Anxiety"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3928\/00485713-20211226-01","article-title":"Sex Differences in the Co-Occurrence of PTSD and Cardiovascular Disease","volume":"52","author":"Seligowski","year":"2022","journal-title":"Psychiatr. Ann."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.cpr.2012.02.002","article-title":"Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: A systematic review and meta-analysis","volume":"32","author":"Morris","year":"2012","journal-title":"Clin. Psychol. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"102923","DOI":"10.1016\/j.autneu.2021.102923","article-title":"Autonomic dysfunction and cardiovascular risk in post-traumatic stress disorder","volume":"237","author":"Fu","year":"2022","journal-title":"Auton. Neurosci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Lo, C.K., Mertz, D., and Loeb, M. (2014). Newcastle-Ottawa Scale: Comparing reviewers\u2019 to authors\u2019 assessments. BMC Med. Res. Methodol., 14.","DOI":"10.1186\/1471-2288-14-45"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin. Trials."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2307\/3001666","article-title":"The Combination of Estimates from Different Experiments","volume":"10","author":"Cochran","year":"1954","journal-title":"Biometrics"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e502","DOI":"10.1097\/CCM.0000000000003713","article-title":"Cardiac Arrest and Subsequent Hospitalization\u2013Induced Posttraumatic Stress Is Associated With 1-Year Risk of Major Adverse Cardiovascular Events and All-Cause Mortality","volume":"47","author":"Agarwal","year":"2019","journal-title":"Crit. Care Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1097\/PSY.0000000000000565","article-title":"The Long-Term Clinical Outcome of Posttraumatic Stress Disorder with Impaired Coronary Distensibility","volume":"80","author":"Ahmadi","year":"2018","journal-title":"Psychosom. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e011040","DOI":"10.1161\/CIRCOUTCOMES.124.011040","article-title":"Posttraumatic Stress Disorder and the Risk of Heart Failure Hospitalizations Among Individuals With Coronary Artery Disease","volume":"17","author":"Almuwaqqat","year":"2024","journal-title":"Circ. Cardiovasc. Qual. Outcomes"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.genhosppsych.2015.10.002","article-title":"High prevalence of posttraumatic stress in patients with primary hypertension","volume":"38","author":"Balint","year":"2016","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.jagp.2014.12.003","article-title":"PTSD and Risk of Incident Cardiovascular Disease in Aging Veterans","volume":"24","author":"Beristianos","year":"2016","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1097\/PSY.0b013e31817bccaf","article-title":"A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: Implications for surveillance and prevention","volume":"70","author":"Boscarino","year":"2008","journal-title":"Psychosom. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.ahj.2014.05.015","article-title":"Invasive coronary procedure use and outcomes among veterans with posttraumatic stress disorder: Insights from the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program","volume":"168","author":"Bradley","year":"2014","journal-title":"Am. Heart J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1192\/bjp.bp.113.143610","article-title":"Risk of stroke among patients with post-traumatic stress disorder: Nationwide longitudinal study","volume":"206","author":"Chen","year":"2015","journal-title":"Br. J. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1080\/13607860701366152","article-title":"Posttraumatic stress and co-morbidity following myocardial infarction among older patients: The role of coping","volume":"12","author":"Chung","year":"2008","journal-title":"Aging Ment. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/epirev\/mxt005","article-title":"Gender differences of postdeployment post-traumatic stress disorder among service members and veterans of the Iraq and Afghanistan conflicts","volume":"36","author":"Jacobson","year":"2014","journal-title":"Epidemiol. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"506","DOI":"10.3325\/cmj.2008.4.506","article-title":"Changes in plasma lipid concentrations and risk of coronary artery disease in army veterans suffering from chronic posttraumatic stress disorder","volume":"49","author":"Malec","year":"2008","journal-title":"Croat. Med. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.amjcard.2018.04.007","article-title":"Post-Traumatic Stress Disorder and Heart Failure in Men Within the Veteran Affairs Health System","volume":"122","author":"Fudim","year":"2018","journal-title":"Am. J. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e003010","DOI":"10.1161\/JAHA.115.003010","article-title":"Posttraumatic Stress Disorder Is Associated With Worse Endothelial Function Among Veterans","volume":"5","author":"Grenon","year":"2016","journal-title":"J. Am. Heart Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e014372","DOI":"10.1161\/JAHA.119.014372","article-title":"Analysis of Posttraumatic Stress Disorder, Depression, Anxiety, and Resiliency Within the Unique Population of Spontaneous Coronary Artery Dissection Survivors","volume":"9","author":"Johnson","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.jad.2022.09.117","article-title":"Posttraumatic stress disorder, cardiovascular disease outcomes and the modifying role of socioeconomic status","volume":"319","author":"Kim","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1002\/jts.22766","article-title":"Early life stress and autonomic response to acute mental stress in individuals with coronary heart disease","volume":"35","author":"Kim","year":"2022","journal-title":"J. Trauma. Stress"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.jpsychores.2011.12.011","article-title":"Posttraumatic growth in coronary artery disease outpatients: Relationship to degree of trauma and health service use","volume":"72","author":"Leung","year":"2012","journal-title":"J. Psychosom. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e202734","DOI":"10.1001\/jamanetworkopen.2020.2734","article-title":"Association of Posttraumatic Stress Disorder With Mental Stress-Induced Myocardial Ischemia in Adults After Myocardial Infarction","volume":"3","author":"Lima","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1017\/S2045796024000052","article-title":"Post-traumatic stress disorder as a risk factor for major adverse cardiovascular events: A cohort study of a South African medical insurance scheme","volume":"33","author":"Didden","year":"2024","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Nesic, M., Vogel, J., Kr\u00fcger, J.P., Wenzel, W., Sahebi, A., Rassaf, T., Siebermair, J., and Wesemann, U. (2023). Association between different dimensions of anger and symptoms of post-traumatic stress disorder in at-risk cardiovascular patients during the COVID-19 pandemic. Front. Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1228192"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/S0147-9563(03)00097-9","article-title":"Posttraumatic stress disorder in first-time myocardial infarction patients","volume":"32","author":"Pedersen","year":"2003","journal-title":"Heart Lung"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2996","DOI":"10.1161\/STROKEAHA.119.026854","article-title":"Posttraumatic Stress Disorder and Risk for Stroke in Young and Middle-Aged Adults: A 13-Year Cohort Study","volume":"50","author":"Rosman","year":"2019","journal-title":"Stroke"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1067\/mtc.2000.108162","article-title":"Health-related quality of life and post-traumatic stress disorder in patients after cardiac surgery and intensive care treatment","volume":"120","author":"Stoll","year":"2000","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e032819","DOI":"10.1161\/JAHA.123.032819","article-title":"Posttraumatic Stress Disorder After Spontaneous Coronary Artery Dissection: A Report of the International Spontaneous Coronary Artery Dissection Registry","volume":"13","author":"Sumner","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/j.jacc.2013.04.085","article-title":"Post-traumatic stress disorder and incidence of coronary heart disease: A twin study","volume":"62","author":"Vaccarino","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.biopsych.2021.09.016","article-title":"Posttraumatic Stress Disorder, Myocardial Perfusion, and Myocardial Blood Flow: A Longitudinal Twin Study","volume":"91","author":"Vaccarino","year":"2022","journal-title":"Biol. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1093\/eurheartj\/ehq354","article-title":"Stiffness of large arteries and cardiovascular risk in patients with post-traumatic stress disorder","volume":"32","author":"Walczewska","year":"2011","journal-title":"Eur. Heart J."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Wells, A., Heal, C., Reeves, D., and Capobianco, L. (2023). Prevalence of post-traumatic stress and tests of metacognition as a PTSD risk marker in patients with coronary heart disease and elevated HADS scores: Analysis of data from the PATHWAY RCT\u2019s in UK cardiac rehabilitation. Front. Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1198202"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1177\/1039856218789779","article-title":"The association between post-traumatic stress disorder and coronary artery disease: A meta-analysis","volume":"26","author":"Akosile","year":"2018","journal-title":"Australas. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/j.biopsych.2013.01.019","article-title":"Posttraumatic stress disorder and impaired autonomic modulation in male twins","volume":"73","author":"Shah","year":"2013","journal-title":"Biol. Psychiatry"},{"key":"ref_51","first-page":"214","article-title":"Neurobiological Insights into PostTraumatic Stress Disorder","volume":"5","author":"Demirci","year":"2024","journal-title":"JEB Med. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1097\/PSY.0000000000000110","article-title":"Posttraumatic stress, heart rate variability, and the mediating role of behavioral health risks","volume":"76","author":"Dennis","year":"2014","journal-title":"Psychosom. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"4661","DOI":"10.1111\/ejn.16445","article-title":"New recognition of the heart-brain axis and its implication in the pathogenesis and treatment of PTSD","volume":"60","author":"Li","year":"2024","journal-title":"Eur. J. Neurosci."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Lee, J., Lee, S., Zhang, H., Hill, M.A., Zhang, C., and Park, Y. (2017). Interaction of IL-6 and TNF-\u03b1 contributes to endothelial dysfunction in type 2 diabetic mouse hearts. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0187189"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1152\/jn.00345.2024","article-title":"On the role of epigenetic modifications of HPA axis in posttraumatic stress disorder and resilience","volume":"133","author":"Khan","year":"2025","journal-title":"J. Neurophysiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1037\/hea0000593","article-title":"Association between posttraumatic stress disorder and lack of exercise, poor diet, obesity, and co-occuring smoking: A systematic review and meta-analysis","volume":"37","author":"Secrest","year":"2018","journal-title":"Health Psychol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1037\/hea0001174","article-title":"Physical inactivity, cigarette smoking, and psychiatric comorbidity among veterans with posttraumatic stress disorder","volume":"41","author":"Whitworth","year":"2022","journal-title":"Health Psychol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1080\/03007995.2021.1978417","article-title":"Prevalence of post-traumatic stress disorder in the United States: A systematic literature review","volume":"37","author":"Schein","year":"2021","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1001\/jamapsychiatry.2021.1126","article-title":"Improving the Assessment of COVID-19-Associated Posttraumatic Stress Disorder-Reply","volume":"78","author":"Janiri","year":"2021","journal-title":"JAMA Psychiatry"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/S2215-0366(16)30377-7","article-title":"Post-traumatic stress disorder and cardiovascular disease","volume":"4","author":"Edmondson","year":"2017","journal-title":"Lancet Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.biopsych.2006.06.004","article-title":"Neurocircuitry models of posttraumatic stress disorder and extinction: Human neuroimaging research--past, present, and future","volume":"60","author":"Rauch","year":"2006","journal-title":"Biol. Psychiatry"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/S0140-6736(16)31714-7","article-title":"Relation between resting amygdalar activity and cardiovascular events: A longitudinal and cohort study","volume":"389","author":"Tawakol","year":"2017","journal-title":"Lancet"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e1912200","DOI":"10.1001\/jamanetworkopen.2019.12200","article-title":"Association of Optimism With Cardiovascular Events and All-Cause Mortality: A Systematic Review and Meta-analysis","volume":"2","author":"Rozanski","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s11886-023-01870-1","article-title":"Posttraumatic Stress Disorder as a Consequence of Acute Cardiovascular Disease","volume":"25","author":"Princip","year":"2023","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1002\/jts.21848","article-title":"National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria","volume":"26","author":"Kilpatrick","year":"2013","journal-title":"J. Trauma. Stress"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.psychres.2015.10.017","article-title":"Physical activity in the treatment of Post-traumatic stress disorder: A systematic review and meta-analysis","volume":"230","author":"Rosenbaum","year":"2015","journal-title":"Psychiatry Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.biopsycho.2005.11.013","article-title":"The role of vagal function in the risk for cardiovascular disease and mortality","volume":"74","author":"Thayer","year":"2007","journal-title":"Biol. Psychol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/22\/7979\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T09:25:59Z","timestamp":1762853159000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/22\/7979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":67,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["jcm14227979"],"URL":"https:\/\/doi.org\/10.3390\/jcm14227979","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,11]]}}}