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Middle-aged women who were sexually abused as children may be more likely to develop early signs of heart disease, a new study suggests.
"Early life adversities may have implications for the development of risk factors for heart disease during midlife," said lead researcher Rebecca Thurston, director of the Women's Biobehavioural Health Laboratory at the University of Pittsburgh.
Hardening of the arteries
Thurston's team collected data on 1,400 white, black, Hispanic and Chinese women, aged 42 to 52. They were part of a national study that included women from Boston; Chicago; Detroit; Los Angeles; Pittsburgh; Newark, New Jersey; and Oakland, California.
The investigators found that women who were sexually abused in childhood showed signs of hardening of the arteries in their neck, an early marker of heart disease. This wasn't seen in women who weren't sexually abused, Thurston said. This finding was not connected to traditional risk factors for heart disease, such as obesity, smoking and cholesterol, she added.
Read: Signs of sexual abuse
Thurston noted that the study doesn't prove that child sexual abuse causes heart disease, only that there is an association between the two.
"To prove cause-and-effect, you would have to have a randomized trial assigning some girls to abuse and others not, which obviously one would not do," she explained. "All research around child abuse and health outcomes are purely associational."
Although it isn't clear what factors create the association, there may be changes in the nervous system or an excess of stress hormones, Thurston said. In addition, some of these women may engage in riskier health behaviours.
Very sensitive area
Whether or not a woman should tell her doctor that she was sexually abused as a child is her choice, Thurston added.
"It's a question of how safe a woman feels with her doctors," she said. "This is a very sensitive area, and there has to be trust when a woman discusses these issues with her doctor. But if she has that kind of trust, it would be worth mentioning," she suggested.
"Doctors should be aware of the importance of psychosocial risk factors when understanding women's heart disease risk," Thurston added.
Read: Heart disease – the risk factors
The report was published online in the journal Stroke.
Dr. Gregg Fonarow, professor of cardiology at the David Geffen School of Medicine at the University of California, Los Angeles, said the new study and other research "suggests that exposure to substantial psychosocial stress in childhood can impact the subsequent risk of developing cardiovascular disease."
Another expert, Dr. Tara Narula, associate director of the cardiac care unit at Lenox Hill Hospital in New York City, agreed.
Long-term damage
"An individual's current psychological state is increasingly recognized as an important contributor to heart disease risk, and now we may be seeing that early life stress may be just as critical to identify," she said.
It's not surprising, Narula said, that women suffering a childhood trauma as serious and life-altering as sexual abuse might sustain long-term damage to the health of their heart.
"This first-of-its-kind study definitely merits further investigation and research. Overall, it raises awareness for both doctors and patients that, while difficult to disclose, there may be benefit in terms of heart health in discussing any history of sexual abuse," Narula said.
For the study, the women were asked about whether they had suffered any physical or sexual abuse. In addition, they were tested annually for a number of risk factors for heart disease.
About 16 percent of all the women said they had been sexually abused. Among black women, up to 20 percent reported being sexually abused, the researchers said.
After 12 years, as the women began to enter menopause, they were given an ultrasound test during their last annual visit, to see if any plaque had accumulated in their carotid arteries. Those arteries carry blood from the heart to the brain and face.
The researchers found that women who had been sexually abused had more plaque build-up in those arteries than those who had not been sexually abused. Whether they had been physically abused was not related to thicker carotid arteries, the researchers noted.
Read more:
Focus on child sexual abuse
Breaking the silence after sexual abuse
Child sexual abuse causes psychosis
Image: Human heart from Shutterstock
