Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Maturitas. 2021 Nov;153:48-60. doi: 10.1016/j.maturitas.2021.07.014. Epub 2021 Aug 4.
Cardiovascular disease (CVD) is a leading cause of death among adults. Over 35% of women worldwide report lifetime exposure to sexual violence. While psychosocial factors broadly have been linked to CVD risk, it is unclear if a history of sexual violence is associated with increased risk for CVD. This study employed quantitative meta-analysis to investigate the association between sexual violence and CVD risk.
PubMed and PsycINFO databases were searched through March 1, 2021. Included articles had a measure of sexual violence and at least one cardiovascular outcome (i.e., clinical CVD, subclinical CVD, select CVD risk factors) in women and men aged 18 years or older. Data were expressed as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI) extracted from fully-adjusted models. OR and HR effects were pooled separately, given the inability to statistically harmonize these effects and differences in interpretation, using random effects meta-analysis. Heterogeneity of effects was tested using Cochran's Q test.
Overall, 45 articles based on 830,579 adults (77.1% women) were included (113 individual effects expressed as OR and 9 individual effects expressed as HR). Results indicated that sexual violence was related to adult CVD risk (OR [95%CI] = 1.25 [1.11-1.40]; HR [95%CI] = 1.17 [1.05-1.31]). Results varied by outcome type and measurement, and timing of violence.
Adults with a history of sexual violence demonstrate greater CVD risk relative to those without this history. The results highlight the importance of addressing sexual violence in CVD risk reduction efforts.
心血管疾病（CVD）是成年人死亡的主要原因。全球超过 35%的女性报告一生中曾遭受过性暴力。虽然心理社会因素与 CVD 风险广泛相关，但尚不清楚性暴力史是否与 CVD 风险增加有关。本研究采用定量荟萃分析来研究性暴力与 CVD 风险之间的关联。
通过 2021 年 3 月 1 日检索 PubMed 和 PsycINFO 数据库。纳入的文章均测量了性暴力，并在年龄为 18 岁或以上的女性和男性中至少有一个心血管结局（即临床 CVD、亚临床 CVD、特定 CVD 风险因素）。数据以比值比（OR）或风险比（HR）表示，其 95%置信区间（CI）从完全调整的模型中提取。由于无法从统计学上协调这些效应和解释上的差异，因此分别使用随机效应荟萃分析来汇总 OR 和 HR 效应。使用 Cochran's Q 检验测试效应的异质性。
总体而言，纳入了 45 篇基于 830579 名成年人（77.1%为女性）的文章（113 个个体效应表示为 OR，9 个个体效应表示为 HR）。结果表明，性暴力与成人 CVD 风险相关（OR [95%CI] = 1.25 [1.11-1.40]；HR [95%CI] = 1.17 [1.05-1.31]）。结果因结局类型和测量、暴力发生时间而有所不同。
有性暴力史的成年人比没有性暴力史的成年人 CVD 风险更高。这些结果强调了在 CVD 风险降低工作中解决性暴力问题的重要性。
