Sexual abuse in childhood linked to signs of atherosclerosis in midlife

Women who were sexually abused as children may show signs of atherosclerosis, an early indication of cardiovascular disease, according to new research in the American Heart Association journal Stroke.

This is the first study to suggest a link between sexual abuse and higher carotid artery intima-media thickness (IMT) – thickening of the inner lining of the arteries that may indicate early atherosclerosis.

Atherosclerosis can lead to heart disease and other forms of cardiovascular disease. The carotid artery supplies oxygenated blood to the head and neck, and its thickness is measured using non-invasive ultrasound.

The study of 1,400 Caucasian, African-American, Hispanic and Chinese women 42-52 years old found that those with a history of childhood sexual abuse had higher carotid artery IMT at midlife than those without a history of abuse. The link between childhood abuse and IMT was not explained by standard cardiovascular disease risk factors, such as blood pressure, lipids, and body mass.

Researchers also found:

• About 16 percent of the women reported a history of childhood sexual abuse, across all racial groups, with the abuse as high as 20 percent among African-Americans.
• A history of childhood sexual abuse, but not childhood physical abuse, was related to higher IMT.

"These study findings indicate the importance of considering early life stressors on women's later cardiovascular health," said Rebecca C. Thurston, Ph.D., study lead author and associate professor of psychiatry, psychology, epidemiology and clinical and translational science and director of the Women's Behavioral and Health Laboratory at the University of Pittsburgh in Pennsylvania.

"Awareness of the long-term mental and physical consequences of sexual abuse in childhood needs to be heightened nationally, particularly among women and health professionals."

Researchers began their work in 1996, drawing participants from the Study of Women's Health Across the Nation (SWAN), a study in Boston, Chicago, Detroit, Los Angeles, Newark, Pittsburgh and Oakland.

The women transitioning through menopause were questioned about childhood and adult physical and sexual abuse and for a range of well-established heart disease risk factors.

Researchers analyzed the women annually for the next dozen years. At the 12th visit, they underwent carotid artery ultrasound to detect carotid IMT and carotid artery plaque.

"Women who have a history of childhood sexual abuse should report it to their physicians and healthcare providers," Thurston said. "If physicians are able, they should ask about child abuse. Considering child abuse can be important in understanding a woman's cardiovascular risk."

Psychosocial factors are important to the development of cardiovascular disease, the leading cause of death among women in the United States, researchers said.

Thurston plans to continue the study and to research the effect of violence against women and the development of heart disease.