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Violence may increase risk for carotid atherosclerosis in women
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Women who experience physical violence as an adult have almost double the risk for carotid atherosclerosis, an early predictor of stroke, according to research presented at the American Heart Association’s EPI/Lifestyle Scientific Sessions.
“Both society and the health care sector need to be aware of the importance of exposure to violence and its impact, not only on social well-being, but also on women’s long-term health,” Mario Flores, MD, research assistant at the National Institute of Public Health in Mexico City, said in a press release.
Flores and colleagues investigated the relationship between exposure to violence and carotid intima-media thickness in 634 healthy women from the Mexican Teachers’ Cohort. The women (mean age, 49 years) answered 12 violence-related questions from the Life Stressor Checklist questionnaire and underwent ultrasound to determine carotid intima-media thickness. Carotid atherosclerosis was defined as an intima-media thickness of at least 0.8 mm or plaque. In addition, violence was categorized as physical or sexual violence, observed violence, and physical or emotional neglect in childhood and adulthood.
According to the findings, 8.2% of the women had experienced neglect, 22.2% observed violence, 6.9% experienced sexual violence and 8.2% physical violence during their childhood. As adults, 17.4% of the women reported neglect, 21.6% observed violence, 10.4% experienced sexual violence and 27.4% physical violence.
Flores and colleagues reported that there was no significant relationship between exposure to violence in childhood and carotid intima-media thickness, but that in adulthood, the stressors of physical violence affected carotid intima-media thickness. Women who experienced physical violence had an increased risk for carotid atherosclerosis (adjusted OR = 1.69; 95% CI, 1.07-2.69) compared with those women who never reported physical violence.
“Although our findings support the theory that exposure to certain types of violence may have an impact on women’s health, further analysis and studies must be performed in order to generate solid data to be able to change clinical practice and guide public health interventions,” Flores said in the release. – by Tracey Romero
Reference:
Flores M, et al. Abstract P202. Presented at: EPI/Lifestyle Scientific Sessions; March 1-4, 2016; Phoenix.
Disclosure: The study was funded by AstraZeneca, the Bernard Lown Scholars in Cardiovascular Health Program and the Mexican National Council of Science and Technology. Flores reports no relevant financial disclosures. Another researcher reports receiving a nonrestricted investigator-initiated grant from AstraZeneca.
Perspective
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Donna Arnett, PhD, MSPH
I found the difference between childhood and adulthood violence interesting. I thought childhood violence would be more impactful and was surprised that sexual violence didn’t have a stronger link with atherosclerosis.
Future research should look to understand the mechanisms by which violence increases the risk for carotid atherosclerosis in women as well as identify who is at risk and how much we can help women escape these situations.
More research in this area is needed, in general. What is troubling is that this study was done in Mexico where violence against women is high. Given the high prevalence of physical violence in adults we should be asking these questions more often.
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