Exposure to violence and carotid artery intima-media thickness in Mexican women

Mario H. Flores-Torres, Rebekka Lynch, Ruy Lopez-Ridaura, Elsa Yunes, Adriana Monge, Eduardo Ortiz-Panozo, Carlos Cantu-Brito, Arna Hauksdóttir, Unnur Valdimarsdóttir, Martín Lajous*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article numbere006249
JournalJournal of the American Heart Association
Volume6
Issue number8
DOIs
Publication statusPublished - 1 Aug 2017

Bibliographical note

Funding Information:
This project was partly funded by an unrestricted investigator-initiated grant from AstraZeneca (ISSNPCV0022) and by the National Council of Science and Technology’s Fund for Health Research and Social Security (CONACYT-SALUD 161786) and Projects for Scientific Development to Deal with National Problems (PDCPN2013-01-214145).

Publisher Copyright:
© 2017 The Authors and Medtronic.

Other keywords

  • Cardiovascular disease
  • Carotid intima-media thickness
  • Stress
  • Violence
  • Women

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