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Patients who experienced sexual violence during their lifetime had a higher risk of adverse cardiovascular outcomes later on, according to results of a systematic review and meta-analysis.

Exposure to sexual violence was associated with an increased risk of developing cardiovascular disease (OR 1.25, 95% CI 1.10-1.41), reported Karen Jakubowski, PhD, of the University of Pittsburgh Medical Center, and colleagues.

Patients who experienced sexual violence during childhood appeared to be especially at risk, Jakubowski noted in her presentation during the North American Menopause Society (NAMS) virtual meeting.

"Even summarizing across a really diverse group of studies, we still found that overall take-home message, that sexual violence history is related to increased cardiovascular disease risk," she told MedPage Today. "That, to me, was really striking."

In a subgroup analysis, the researchers observed a stronger effect of sexual abuse starting in childhood compared with violence that occurred for the first time during adulthood. These findings underscored the potential long-term health impacts of childhood trauma, but future research is needed to assess how the timing and frequency of sexual violence further impacts health risks, Jakubowski added.

"We know that adversity in general impacts cardiovascular disease risk," Stephanie Faubion, MD, MBA, medical director of NAMS, told MedPage Today. Faubion, who was not involved with this research, added that these findings should encourage physicians to pay further attention to "adversity, and particularly childhood adversity, because it really does set people up for poor health later on."

Over 35% of women have experienced sexual violence during their lifetime, Jakubowski's group said. There is evidence that adverse psychosocial outcomes have some impact on cardiovascular disease risk, but there is no summarized data on the specific risks of sexual violence.

Jakubowski and colleagues analyzed 45 studies including 830,000 adults that explored the relationship between cardiovascular disease and exposure to sexual violence. All studies included a measure of sexual violence, including sexual abuse or assault, military sexual trauma, or sexual harassment or sexual intimate partner violence, and analyzed at least one adverse cardiovascular outcome. Studies published up until March of this year were included in the analysis. About 77% of study participants were women.

In addition to differences in risk based on the timing of violence, the researchers noted stronger associations for clinical cardiovascular disease compared with subclinical disease, and self-reported outcomes compared with medical records or direct measurements.

Jakubowski acknowledged that the majority of studies in this analysis were conducted in the U.S., and predominantly among white people. Because people of diverse gender and racial backgrounds are more likely to experience sexual violence, she said that these results may not be generalizable to marginalized communities, adding that future research should address the experience of minority groups.

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