Objective To determine the relationship between post-traumatic stress disorder (PTSD) and hypertension among asylum seekers in the Netherlands.
Methods Data were obtained from the Dutch national electronic database of the Community Health Services for Asylum Seekers (MOA) from 2000 to 2008. Asylum seekers aged ≥18 years at arrival in the reception facilities were included in this study (N=105 180). The diagnosis of hypertension was coded according to the Dutch list of the International Classification of Primary Care, while PTSD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria.
Results People with PTSD were more likely than those without PTSD to have hypertension even after adjusting for age, sex, world region of origin, length of stay in the Netherlands, and obesity (OR=1.72, 95% CI 1.50 to 1.96). There was an interaction between PTSD and co-morbid depression (p=0.006), indicating that the effect of PTSD and depression on hypertension were independent. When the analyses were stratified by depression status, among non-depressed group, individuals with PTSD had higher odds of hypertension than those without PTSD (OR=1.36, 95% CI 1.17 to 1.59). However, among the depressed individuals, there was no association between PTSD and hypertension even after adjustment for other factors: 1.09 (95% CI 0.77 to 1.53).
Conclusions Our findings suggest that there is a positive relationship between PTSD and hypertension among asylum seekers in the Netherlands; and this relationship is independent of comorbid depression. Clinicians and policy makers need to take history of PTSD into account when screening and treating asylum seekers for hypertension.
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