The Association between Sexual Violence and Cardiovascular Disease: An Analysis using Data from the 2017 Alaska Behavioral Risk Factor Surveillance System

Abstract

Cardiovascular diseases represent a significant portion of deaths among women in the United States. Research has suggested that abuse and violence may be risk factors for cardiovascular diseases. Nearly 1 in 3 women in the United States have experienced some form of sexual violence in their lifetime, with Native Alaskan women experiencing a significantly greater burden than the national average. The objective of this study was to examine the association between sexual violence and cardiovascular disease, and whether this association is modified by race. Data were obtained from the 2017 Alaska Behavioral Risk Factor Surveillance System. The study population (N=1,049) was restricted to female respondents age 45-80 years who provided data on sexual violence, cardiovascular disease, and the covariates included in the models. Poisson regression was used to estimate unadjusted and adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs). To assess effect modification by race, data were stratified by race (White and Native Alaskan) and PRs (and 95% CIs) were calculated. Interaction models were fit to assess statistical significance of the interaction. A lifetime history of sexual violence was associated with a 71% greater prevalence of cardiovascular disease (adjusted PR 1.71 95% CI 1.61-1.81). The association between sexual violence and cardiovascular disease was significantly stronger among Native Alaskan women (adjusted PR 14.1, 95% CI 9.59-20.7) compared with the association among White women (adjusted PR 1.62, 95% CI 1.52-1.72) (P-value for interaction < 0.05). Female residents of Alaska, particularly Native Alaskan women, who have experienced sexual violence have a greater burden of cardiovascular disease than non-exposed female residents. Survivors of sexual violence have unique healthcare needs, which should include prevention and treatment of cardiovascular diseases.