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

• Published in: Journal of the American Heart Association Vol. 6; no. 8
• Main Authors: Flores‐Torres, Mario H., Lynch, Rebekka, Lopez‐Ridaura, Ruy, Yunes, Elsa, Monge, Adriana, Ortiz‐Panozo, Eduardo, Cantu‐Brito, Carlos, Hauksdóttir, Arna, Valdimarsdóttir, Unnur, Lajous, Martín
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 01.08.2017; Wiley
• Subjects: Adult; Age Factors; Asymptomatic Diseases; cardiovascular disease; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Carotid Artery Diseases - psychology; Carotid Intima-Media Thickness; Checklist; Crime Victims - psychology; Cross-Sectional Studies; Exposure to Violence - psychology; Humans; Linear Models; Logistic Models; Medicin och hälsovetenskap; Mexico - epidemiology; Middle Aged; Multivariate Analysis; Odds Ratio; Original Research; Physical Abuse - psychology; Predictive Value of Tests; Prevalence; Risk Factors; School Teachers; Sex Factors; Sex Offenses - psychology; stress; Stress, Psychological - epidemiology; Stress, Psychological - psychology; violence; women; Women's Health; cardiovascular disease; stress; carotid intima‐media thickness; violence; women
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.117.006249

Background Violence 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 Results We 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). Conclusions Exposure to violence, and in particular assault by a stranger, was strongly associated with subclinical cardiovascular disease in Mexican middle‐aged women.