Hypertension in adult survivors of child abuse: observations from the Nurses' Health Study II
Open accessAbstract
BACKGROUND: Limited research has shown a possible association between exposure to physical or sexual abuse prior to age 18 and the risk of developing hypertension as an adult. The factors mediating this relationship are unknown. METHODS: Questionnaire data from 68 505 female participants in the Nurses' Health Study II were analysed regarding exposure to physical and sexual abuse prior to age 18. Cox proportional hazards regression was used to assess the relationship between abuse exposure and hypertension. RESULTS: 64% of the participants (n=41 792) reported physical and/or sexual abuse prior to age 18; 17% reported hypertension. All forms of abuse had a dose-response relationship with hypertension. Adjustments for smoking, alcohol, family history of hypertension, exercise and oral contraceptives did not alter risk estimates. Adjustment for body mass index (BMI) significantly attenuated the associations between abuse and risk of hypertension and accounted for approximately 50% of the observed association between abuse exposure and hypertension. Women experiencing forced sexual activity as a child and as an adolescent had a 20% increased risk for developing hypertension (95% CI 8% to 32%) that was independent of BMI. Similarly, women reporting severe physical abuse in childhood and/or adolescence had risk estimates ranging from 14% (95% CI 5% to 24%) to 22% (95% CI 11% to 33%). CONCLUSION: Early interpersonal violence may be a widespread risk factor for the development of hypertension in women. BMI is a significant mediator in the relationship between early abuse and adult hypertension.
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Analyses of tubal infertility additionally adjusted for history of sexual abuse, finer race/ethnicity, household income, and endometriosis.
“Since tubal infertility has several specific risk factors, we conducted analyses of tubal infertility adjusting for additional potential confounding variables. We also adjusted for history of sexual abuse.(23) We also more finely adjusted for race/ethnicity (white (ref), Hispanic, black, other) and household income (<$15,000, $15–19,999, $20–29,999, $30–39,999, $40–49,999, $50–74,999, $75–99,999,”
From Infertility, fertility treatment, and risk of hypertension (2015) · cites this paper as [23]
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- Authors
- Riley, E. H., Wright, R. J., Jun, H. J., Hibert, E. N., & Rich-Edwards, J. W.
- Affiliations
- Massachusetts General Hospital (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Riley, E H
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2010-05
- Volume
- 64
- Issue
- 5
- Pages
- 413-418
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- PMC
- PMC3744368
- OpenAlex
- W2134192460
- Cited by
- 124
- References
- 50
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 3 · 2023: 7 · 2022: 11 · 2021: 11 · 2020: 7 · 2019: 10 · 2018: 7 · 2017: 8 · 2016: 8 · 2015: 11 · 2014: 7 · 2013: 5 · 2012: 12
- FWCI
- 7.05
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL064108, R01HL081557, HL64108, HL081557)
- National Cancer Institute (CA50385, R01CA050385)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Social Sciences › Health › Intimate Partner and Family Violence
- Keywords
- childhood abuse, physical abuse, sexual abuse, hypertension, body mass index, mediation, women, Nurses' Health Study II
- MeSH terms
- Adolescent, Adult, Child, Child Abuse, Female, Humans, Hypertension, Male, Surveys and Questionnaires, Risk Factors, Nursing Methodology Research, Body Mass Index, Proportional Hazards Models, Survivors, Young Adult
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