Abstract P202: Violence and Midlife Carotid Artery Intima-media Thickness in Mexican Women

Introduction: Violence against women remains globally one of the most important human rights violations and public health threats. Yet, data on the potential impact of lifetime exposure to violence, an important stressor, on cardiovascular disease (CVD) are scarce. Hypothesis: Adult women with a history of childhood and/or adult exposure to violence are at increased risk of subclinical CVD compared to women without this history. Methods: We evaluated the association of childhood and adult exposure to violence and carotid artery intima-media thickness (IMT) in 634 disease-free women from the Mexican Teachers’ Cohort. In 2012-13, study participants retrospectively responded to 12 violence-related items from the Life Stressor Checklist questionnaire. We categorized violence as neglect, and observed, physical and sexual violence, in childhood and adulthood. IMT was measured by standardized neurologists through ultrasound and log-transformed. We defined carotid atherosclerosis as IMT ≥0.8mm or plaque. We used multivariable linear and logistic regression models to assess the association between violence, IMT and carotid atherosclerosis. Results: In childhood, the prevalence of neglect was 8.2%, observed violence 22.2%, sexual violence 6.9% and physical violence 8.2%. In adulthood, neglect was present in 17.4% participants, observed violence in 21.6%, sexual violence in 10.4% and physical violence in 27.4%. Childhood exposure to sexual violence appeared to be associated to IMT in midlife but remained non-significant. In adulthood, we observed an association between exposure to physical violence and IMT when comparing exposed to unexposed women (multivariable-adjusted mean % difference=2.3%; 95%CI 0.1, 4.6). The multivariable-adjusted odds ratio for carotid atherosclerosis was 1.69 (95%CI 1.07, 2.69) comparing women who reported physical violence relative to those who did not. Conclusions: Exposure to certain types of violence may be associated with increased subclinical CVD in middle-aged women.