Lifetime Exposure to Violence and Early Cardiometabolic Risk Factors in a Healthy Swedish Cohort.

Abstract

Background: Violence exposure has been associated with cardiovascular disease. Less is known about underlying mechanisms, including early cardiometabolic risk factors, and possible sex differences of such associations.

Methods: We used data from the Swedish LifeGene study on 23 215 men and women, aged 18 to 50 years. Participants answered the Life Stressor Checklist-Revised regarding physical and sexual violence alongside questions on medical diagnoses of hypertension, diabetes, dyslipidemia, and smoking history in 2009 to 2016. At a clinical visit, blood pressure, body mass index, glycated hemoglobin, total cholesterol, apolipoprotein B/apolipoprotein A1 ratio, and hs-CRP (high-sensitivity C-reactive protein) were measured. Modified Poisson and linear regression were used to test the association between violence and cardiometabolic risk factors.

Results: At mean age 33±8 years, lifetime exposure to violence was reported by 23% of women and 15% of men. Those exposed to violence reported higher prevalence of smoking (prevalence ratio [PR], 1.74 [95% CI, 1.56-1.94]) and diagnosis of hypertension (PR, 1.36 [95% CI, 1.15-1.60]) but not hyperlipidemia (PR, 1.06 [95% CI, 0.82-1.36]). Men and women exposed to violence had higher body mass index (Beta, 0.45 [95% CI, 0.39-0.63]) and hs-CRP (Beta, 0.08 [95% CI, 0.04-0.13]), after multivariable adjustment, whereas no differences were observed in glycated hemoglobin (B, 0.04 [95% CI, -0.11 to 0.18]) or total cholesterol (Beta, -0.01 [95% CI, -0.05 to 0.02]), and systolic blood pressure was marginally lower among individuals exposed to violence (B, -0.42 [95% CI, -0.78 to -0.06]).

Conclusions: In a young healthy Swedish sample, lifetime exposure to physical and/or sexual violence was associated with some but not all early cardiometabolic risk factors among both men and women.