(1) report that the incidence of coronary heart disease (CHD) was more than double in twins from the Vietnam Era Twin (VET) Registry who had PTSD compared with those without PTSD. ...they showed that PTSD was associated with significantly lower myocardial perfusion and coronary flow reserve as assessed by positron emission tomography. Autonomic nervous system dysregulation is also associated with PTSD, which can result in reduced heart rate variability and increased QT variability (8), both of which are predictors of adverse cardiovascular outcomes. ...we have a great deal of data to support PTSD as a risk factor for CHD and a number of potential mechanisms through which this risk is manifested.