Young adults who have 1 or more violent episodes with an intimate partner or family member have a significantly increased risk for incident cardiovascular (CV) events and total mortality in middle age, according to study results presented at the American Heart Association (AHA) Scientific Sessions 2022, held from November 5th through 7th, in Chicago, Illinois.
The findings are based on analysis of participants from the CARDIA (Coronary Artery Risk Development in Young Adults) study. The baseline exposure variables (1987-1988) included how frequently within the previous year the participants were involved in a violent argument with a spouse/lover (intimate partner violence), with family other than a spouse, with someone else they knew, with someone they did not know, and whether the participants kept a gun at home for protection.
After 28 years of follow-up, the investigators assessed incident CV events, which were defined as nonfatal myocardial infarction, nonfatal stroke, heart failure hospitalization, and other CV death, as well as total mortality. Cox models were used to evaluate associations between violence exposure status and incidence of CV events or total mortality, with further adjustment for baseline risk factors.
The analysis included up to 4357 participants (54% women) with a mean age of 27 years at baseline. Of the participants who reported having intimate partner violence within the previous year, 62% were Black patients and 38% were White patients.
Intimate partner violence or family violence was associated with at least a 34% increased risk for CV events and at least a 30% increased risk of all-cause death after adjustment for age, sex, and race. Having 1 or more violent episodes with an intimate partner within the past year also increased the risk of death from any cause by 34% after further adjustment for CV risk factors. The individuals who reported a violent episode involving a family member other than a spouse/lover had a 59% increased risk of death, and the rate was 34% if the episode involved someone else they knew and 26% if it involved someone they did not know.
The participants who reported 1 or more intimate partner violence exposures within the past year at the beginning of the study also had increased alcohol consumption (16 mL/day or 0.5 ounces/day) compared with patients with no exposure (11 mL/day or 0.4 ounces/day). In addition, those who reported intimate partner violence exposure within the previous year smoked more cigarettes (3.3 pack-years for those who had intimate partner violence vs 2.4 pack-years for no exposure) and were more likely to report depression (8.3% for intimate partner violence exposure vs 6.0% for no exposure) at the beginning of the study .
Among a few study limitations, the participants were only asked about the number of episodes of intimate partner violence at the beginning of the study, and the definition of what constitutes a “violent or potentially violent argument” is not clearly defined.
“The results suggest that intimate partner violence appears to be very much related to a higher risk of cardiovascular events or death,” lead author Dr Kathryn Recto stated in a press release. “It is imperative that we better understand the association between these two public health problems so that improved interventions can be developed and implemented.”
Recto K, Colangelo LA, Kershaw KN, Lloyd-Jones DM. Association between intimate partner violence and major adverse cardiovascular events: findings from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Presented at: The American Heart Association (AHA) Scientific Sessions 2022; November 5-7, 2022; Chicago, IL. Abstract #MO3022.
Young adults who experienced intimate partner violence may face higher cardiac risks later. Dallas, TX: American Heart Association Scientific Sessions 2022; October 31, 2022.