Sexual Violence and Risk of Hypertension in Women in the Nurses’ Health Study II: A 7‐Year Prospective Analysis

Abstract

Background Hypertension is a prevalent condition in women and an important modifiable risk factor for cardiovascular disease. Despite women’s experiences of sexual violence being common, no prospective studies have examined lifetime sexual assault and workplace sexual harassment in relationship to hypertension in large civilian samples with extended follow‐up. Here, we examined whether these experiences were prospectively associated with greater risk of developing hypertension over 7 years. Methods and Results Data are from a substudy of the Nurses’ Health Study II and include women free of hypertension at the time of sexual assault and workplace sexual harassment assessment in 2008 (n=33 127). Hypertension was defined as self‐reported doctor diagnosis or initiating antihypertensive medication use, assessed biennially through 2015. We performed Cox proportional hazards regression models to predict time to developing hypertension associated with sexual violence exposure, adjusting for relevant covariates. Over follow‐up, 7096 women developed hypertension. Sexual assault and workplace sexual harassment were prevalent (23% and 12%, respectively; 6% of women experienced both). Compared with women with no exposure, women who experienced both sexual assault and workplace sexual harassment had the highest risk of developing hypertension (hazard ratio [HR], 1.21; 95% CI, 1.09–1.35), followed by women who experienced workplace sexual harassment (HR, 1.15; 95% CI, 1.05–1.25) and then by women who experienced sexual assault (HR, 1.11; 95% CI, 1.03–1.19), after adjusting for relevant covariates. Conclusions Sexual assault and workplace sexual harassment are prospectively associated with greater risk of hypertension. Reducing such violence is important in its own right and may also improve women’s cardiovascular health.

Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women

“…For example, in a sample of 51 434 women from the general population, individuals who reported severe emotional abuse had a 24% greater incidence of hypertension, but this association was not found for those who experienced sexual assault [35]. In recent analyses of data from the Nurses’ Health Study, women who experienced sexual assault and workplace sexual harassment showed a 21% greater risk of incident hypertension, followed by a 15% greater risk among women who experienced workplace sexual harassment only, and a 11% greater risk for women who experienced sexual assault only [36]. This study offers meaningful evidence that one's prospective risk for hypertension may vary based on the types of sexual violence that an individual has experienced.…”

Sleeping Difficulties, Sleep Duration, and Risk of Hypertension in Women

“…Additionally, since the women’s chronotype (originally assessed in 5 categories: definite or more likely morning type, definitive or more likely evening type, and neither, which we grouped into 3 categories of morning type, evening type, and neither) was only reported once (2009), it was considered as a time-invariant factor. Time-varying factors were updated throughout follow-up and included physical activity (originally calculated as a continuous variable; we grouped it into previously used categories 39 of <3, 3 to <9, 9 to <18, 18 to <27, 27+ metabolic equivalent hours/week; assessed in 2001, 2005, 2009, and 2013), alcohol use (originally calculated as a continuous variable; we grouped it into previously used categories 39 of 0, 1 to <5, 5 to <10, 10 to <20, and 20+ g/day; assessed in 1999, 2003, 2007, 2011, and 2015), smoking status (originally categorized into 15 groups; we regrouped it into previously used categories 39 of never smokers, former smokers, or current smokers of 1–14, 15–24, or 25+ cigarettes/day; assessed biennially between 2001 and 2017), and menopausal status (originally categorized into 4 groups). We regrouped it into categories of premenopausal or postmenopausal (assessed biennially between 2001 and 2017), shiftwork history (we grouped it into categories of never, <5, 5 to <10, and 10+ years; assessed in 2001, 2005, 2009, 2011, and 2013), diagnosis of sleep apnea (2013 and 2017), diet quality based using Dietary Approaches to Stop Hypertension 40,41 (assessed in 1999, 2003, 2007, and 2011), and body mass index (kg/m 2 ; using updated weight, which was assessed biennially between 2001 and 2017).…”

The Mediating Role of Trust in the Manager in the Effect of Perception of Gender Equality on Sexual Harassment Reporting in the Workplace

“…Negative effects such as post-traumatic stress disorder, compassion burnout (Fabri et al, 2022), depression (Pang et al, 2022), hypertension (Lawn et al, 2022), depersonalisation (Tsukamoto et al, 2022), and intention to leave work (Pang et al, 2022) require the introduction of unique mechanisms in reporting sexual harassment. It is accepted that the fairness of the manager will reinforce the employees' perceptions of trust towards the manager.…”