Abused girls may have higher risk of heart disease, stroke as adults, study suggests

In the study, compared to women who weren't molested or raped as children or teens, women who reported:

• Repeated episodes of forced sex in childhood or adolescence had a 62 percent higher risk of cardiovascular disease as adults.
• Severe physical abuse in childhood or adolescence was associated with a 45 percent increased risk of cardiovascular events.

Mild to moderate physical or sexual abuse was not associated with increased risk.

"The single biggest factor explaining the link between severe child abuse and adult cardiovascular disease was the tendency of abused girls to have gained more weight throughout adolescence and into adulthood,' said Janet Rich-Edwards, Sc.D., M.P.H., lead author of the study and associate professor in the Department of Medicine at Brigham and Women's Hospital in Boston, Mass.

The researchers studied the associations of child and adolescent abuse with confirmed cardiovascular disease events such as heart attacks and strokes from 1989-2007 among 67,102 women in the Nurses' Health Study II. Eleven percent reported forced sexual activity during childhood and adolescence and 9 percent reported severe physical abuse.

Associations of severe abuse were stronger for stroke than for heart attack. Risk factors such as adult body mass index, smoking, alcohol use, hypertension and diabetes accounted for 41 percent of the association of severe physical abuse and 37 percent of the association of forced sex with cardiovascular disease events. "These traditional cardiovascular risk factors explain about 40 percent of the association we see between abuse and cardiovascular disease -- which suggests that other factors may play an important role, such as increased stress reactivity among people with a history of abuse," said Rich-Edwards.

Researchers conducted the study with primarily white nurses, so further research should be done with different socio-demographic groups, Rich-Edwards said.

"Women who experience abuse need to take special care of their physical and emotional well-being to reduce their risk of chronic disease," Rich-Edwards said. "Primary care health professionals need to consider childhood abuse histories of women as they transition into adulthood but to help the health professionals prevent cardiovascular disease among women with a history of abuse, we need to learn more about specific psychological, lifestyle, and medical interventions to improve the health of abuse survivors."

Co-authors are: Susan Mason, Ph.D.; Kathryn Rexrode, M.D.; Donna Spiegelman, Sc.D.; Eileen Hilbert, M.S.; Ichiro Kawachi, Ph.D.; Hee-Jin Jun, Sc.D. and Rosalind Wright, M.D.

The National Institutes of Health funded the study.