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Exposure to sexual violence increases the risk of hypertension in women by 21%

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High blood pressure, or hypertension, affects nearly 43 percent of American women aged 20 and over, with a reading of 130/80 mm Hg or greater.

High blood pressure is a key risk factor for cardiovascular disease, which is the leading cause of mortality among women, accounting for one in every three fatalities each year.

However, exposure to sexual violence is not widely recognized as a contributor to women’s cardiovascular health.

According to the latest report published today in the Journal of the American Heart Association,  women who have experienced sexual assault, workplace sexual harassment, or both are at a higher long-term risk of developing hypertension than women who have never experienced these types of trauma.

Over the course of seven years, researchers looked at data from a follow-up of the Nurses’ Health Study II, which is a long-term study of U.S. women that began in 1989 with 116,429 nurses who were between the ages of 24 and 42. They started by looking at data from a 2008 follow-up. The 2008 follow-up assessed the prevalence of sexual violence and other forms of trauma, as well as post-traumatic stress disorder (PTSD) and depressive symptoms, among a sample of 54,703 original study participants.

The team looked at data from 33,127 women (97 percent non-Hispanic white women; average age of 53 years at the start of the 2008 follow-up) who had no history of hypertension or were not using blood pressure medication at the time of the 2008 follow-up.

The report revealed:

  • At the seven-year follow-up in 2015, approximately one-fifth of the women (nearly 7,100) self-reported having developed hypertension, which was confirmed by medical records.
  • Sexual assault and workplace sexual harassment were both widespread, with lifetime incidence rates of 23 percent for sexual assault and 12 percent for workplace sexual harassment; 6 percent of women said they had experienced both.
  • Women who reported having experienced both sexual assault and workplace sexual harassment had the highest risk of developing hypertension, with a 21 percent increased risk, followed by a 15 percent increased risk for women who reported experiencing workplace sexual harassment and an 11 percent increased risk for women who reported experiencing sexual assault.

“We did not find any association of increased risk for hypertension among women who had a history of other types of trauma and who did not experience sexual violence, suggesting that increased hypertension risk does not appear to be associated with all trauma exposure,” said the authors. “Our finding that experiencing both sexual assault and workplace sexual harassment had the highest risk of hypertension underscores the potential compounding effects of multiple sexual violence exposures on women’s long-term cardiovascular health.”

While primary care providers are increasingly screening for partner violence, sexual violence is not recognized as a risk factor for cardiovascular disease in women, according to the study authors.

The study has a number of drawbacks. Because the data were gathered in the past, it’s possible that memory bias influenced the results. The time and intensity of the sexual assault and workplace sexual harassment were not recorded, which could influence how other traumas and psychological stress affect hypertension. Because the majority of the women in the study were non-Hispanic white women with a professional nursing job in healthcare, the findings may not be generalizable.

Source: 10.1161/JAHA.121.023015

Image Credit: Getty

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