Lifetime Exposure to Violence and Early Cardiometabolic Risk Factors in a Healthy Swedish Cohort

Violence exposure has been associated with cardiovascular disease. Less is known about underlying mechanisms, including early cardiometabolic risk factors, and possible sex differences of such associations.

We used data from the Swedish LifeGene study on 23 215 men and women, aged 18 to 50 years. Participants answered the Life Stressor Checklist-Revised regarding physical and sexual violence alongside questions on medical diagnoses of hypertension, diabetes, dyslipidemia, and smoking history in 2009 to 2016. At a clinical visit, blood pressure, body mass index, glycated hemoglobin, total cholesterol, apolipoprotein B/apolipoprotein A1 ratio, and hs-CRP (high-sensitivity C-reactive protein) were measured. Modified Poisson and linear regression were used to test the association between violence and cardiometabolic risk factors.

At mean age 33±8 years, lifetime exposure to violence was reported by 23% of women and 15% of men. Those exposed to violence reported higher prevalence of smoking (prevalence ratio [PR], 1.74 [95% CI, 1.56-1.94]) and diagnosis of hypertension (PR, 1.36 [95% CI, 1.15-1.60]) but not hyperlipidemia (PR, 1.06 [95% CI, 0.82-1.36]). Men and women exposed to violence had higher body mass index (Beta, 0.45 [95% CI, 0.39-0.63]) and hs-CRP (Beta, 0.08 [95% CI, 0.04-0.13]), after multivariable adjustment, whereas no differences were observed in glycated hemoglobin (B, 0.04 [95% CI, -0.11 to 0.18]) or total cholesterol (Beta, -0.01 [95% CI, -0.05 to 0.02]), and systolic blood pressure was marginally lower among individuals exposed to violence (B, -0.42 [95% CI, -0.78 to -0.06]).

In a young healthy Swedish sample, lifetime exposure to physical and/or sexual violence was associated with some but not all early cardiometabolic risk factors among both men and women.