Exposure to Violence and Carotid Artery Intima‐Media Thickness in Mexican Women

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Elsa Yunes¹  Martín Lajous¹  Eduardo Ortiz‐Panozo¹  Ruy Lopez‐Ridaura¹  Adriana Monge¹  Rebekka Lynch²  Unnur Valdimarsdóttir²  Arna Hauksdóttir³  Carlos Cantu‐Brito⁴  Mario H. Flores‐Torres⁵ 

[1] Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico;Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland;Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden;Department of Neurology and Psychiatry, National Institute of Nutrition and Medical Sciences, Mexico City, Mexico;School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico;

关键词: cardiovascular disease;    carotid intima‐media thickness;    stress;    violence;    women;   

DOI  :  10.1161/JAHA.117.006249

来源: DOAJ

【 摘 要 】

BackgroundViolence against women has become a global public health threat. Data on the potential impact of exposure to violence on cardiovascular disease are scarce. Methods and ResultsWe evaluated the association between exposure to violence and subclinical cardiovascular disease in 634 disease‐free women from the Mexican Teachers' Cohort who responded to violence‐related items from the Life Stressor Checklist and underwent measures of carotid artery intima‐media thickness in 2012 and 2013. We defined exposure to violence as having ever been exposed to physical and/or sexual violence. Intima‐media thickness was log‐transformed, and subclinical carotid atherosclerosis was defined as intima‐media thickness ≥0.8 mm or plaque. We used multivariable linear and logistic regression models adjusted for several potential confounders. Mean age was 48.9±4.3 years. Close to 40% of women reported past exposure to violence. The lifetime prevalence of sexual violence was 7.1%, and prevalence of physical violence was 23.5% (7.7% reported both sexual and physical violence). Relative to women with no history of violence, exposure to violence was associated with higher intima‐media thickness (adjusted mean percentage difference=2.4%; 95% confidence interval 0.5, 4.3) and subclinical atherosclerosis (adjusted odds ratio=1.60; 95% confidence interval 1.10, 2.32). The association was stronger for exposure to physical violence, especially by mugging or physical assault by a stranger (adjusted mean % difference=4.6%; 95% confidence interval 1.8, 7.5, and odds ratio of subclinical carotid atherosclerosis=2.06; 95% confidence interval 1.22, 3.49). ConclusionsExposure to violence, and in particular assault by a stranger, was strongly associated with subclinical cardiovascular disease in Mexican middle‐aged women.

【 授权许可】

Unknown