Introduction:
Women are more likely to experience distress and injury from intimate partner violence (IPV), and may also be at greater risk of higher blood pressure than male victims. However, most prior epidemiologic research has not included men and has not examined perpetation, despite the predominance of mutually violent relationships. Therefore, this study investigates sex differences in the relationship between exposure to IPV victimization and perpetration and systolic blood pressure (SB).
Methods:
The study included 3447 (52% female; mean(sd) age=22(3)) participants of Waves 3 (2001–2002) and 4 (2007) of the publically-available subset of the National Longitudinal Study of Adolescent Health. Frequency of psychological, physical, sexual IPV and IPV-related injury were ascertained with the Revised Conflict Tactics Scales at Wave 3. Exposure to IPV was categorized as no IPV victimization or perpetration (ref), only low victimization and / or perpetration, high victimization and low/no perpetration, high perpetration and low/no victimization, and both high victimization and perpetration. SBP was measured at Wave 4 using standard procedures. Potential confounders (age, educational attainment, race, history of child abuse) and mediators (depressive symptoms, breakfast consumption, moderate physical exercise, BMI, smoking, alcohol consumption) were recorded at Wave 3. Multivariable weighted linear regression was used to test the relationship between SBP and IPV by adjusting for confounders then by adjusting for the proposed mediators. Analyses were stratified by sex and a multiplicative term was tested.
Results:
Approximately 30% of the sample reported IPV exposure (n=2050), of which 23% (n=831) experienced low victimization and or perpetration, 5% (n=157) high victimization, 6% (N=203) high perpetration, 6% (n=206) both high victimization and perpetration. Women were slightly more likely to report high perpetration and both high victimization and high perpetration (p<0.01). In separate models controlling for confounders, experiencing both high victimization and perpetration was associated with 4.02 mmHg SBP higher in men (95% CI: 0.32, 7.72) and 2.51 mmHg SBP higher in women (95% CI: 0.18, 4.84) compared to those with no IPV. In addition, reporting high perpetration was associated with 3.83 mmHg higher SBP in men (95% CI: –0.72, 8.38), while high victimization was associated with 2.94 mmHg higher SBP for women (95% CI: –0.61, 6.49). Further adjustment for the hypothesized mediators slightly attenuated the findings. The multiplicative term (IPV X sex) was marginally significant (p=0.09).
Conclusions:
Exposure to high levels of victimization and perpetration is associated with higher levels of SBP for men and women. High victimization alone is related to higher SBP for women while high perpetration is related to higher SBP for men.
Assessing the physical violence component of the Revised Conflict Tactics Scales when used in heterosexual couples: an item response theory analysis
