What Blood Pressure Does Not Reveal: Intimate Partner Violence Among Adults with Hypertension

Few studies have characterized the patterns and sociodemographic correlates of reported intimate partner violence (IPV) behaviors among people with hypertension. This study characterized IPV among individuals with physician-diagnosed hypertension in Saudi Arabia.

This cross-sectional study recruited 471 individuals with hypertension from multiple healthcare facilities in Saudi Arabia using convenience sampling. IPV was assessed using questions covering physical, emotional/verbal, sexual, and controlling behaviors. "Any reported IPV behavior" was defined as at least one behavior in any domain; domain-specific and multidomain IPV were also examined. The IPV items were not uniformly anchored to a standardized 12-month or lifetime reference period. Sociodemographic differences were assessed using Pearson's chi-square tests. As complete separation occurred in some categories, Firth's bias-reduced penalized logistic regression was used for exploratory estimation of crude odds ratios (ORs) and adjusted ORs (aORs) with 95% confidence intervals (CIs).

Overall, 278 (59.0%) participants reported at least one assessed IPV behavior. Controlling behavior was reported by 212 participants (45.0%), followed by emotional/verbal (28.2%), physical (26.8%), and sexual IPV (13.0%). Multidomain IPV was reported by 33.8%. IPV was reported by 75.5% of women and 33.5% of men. Men had lower odds of reporting IPV than women (aOR = 0.09, 95% CI: 0.04-0.18). Age-related estimates were unstable because all participants aged 36-49 years reported IPV, resulting in complete separation.

Reported IPV behaviors were common in this Saudi sample. Controlling behavior was the most frequently reported domain, and about one-third reported multidomain IPV, indicating the importance of recognizing non-physical forms of IPV among people with hypertension. Larger, representative studies using standardized IPV measures are needed to confirm these findings and to examine potential relationships between IPV and cardiovascular health outcomes.