부산대학교 도서관

Background: Data are limited on the associations between intimate partner violence (IPV) in young adulthood with the incidence of cardiovascular (CV) events in middle age, and it is unclear how these associations may be affected by other CV risk factors.Methods: We included up to 4357 CARDIA participants (ppts). Exposure variables measured at baseline (1987-1988) included how often in the past year ppts became involved in a violent argument 1) with a spouse/lover (IPV), 2) with family other than spouse, 3) with someone else they knew, 4) with someone they did not know, and 5) whether the ppts kept a gun at home for protection. Over 28 years of follow up, we assessed incident CV events (defined as non-fatal myocardial infarction, non-fatal stroke, heart failure hospitalization, and other CV death) and total mortality. We used Cox models to examine associations between violence exposure status and incidence of CV events or total mortality, with additional adjustment for baseline risk factors.Results: At baseline, mean age was 27 years with 54% female ppts. Ppts exposed to IPV in the last year were more likely to be Black (62% vs. 42% of those unexposed to IPV). Ppts with at least one violence exposure in the past year also had higher rates of alcohol use, smoking, and depression. With adjustment for age/sex/race, exposure to IPV, family violence, and keeping a gun were associated with incident CV events and total mortality (Table). While these associations were attenuated with adjustment for CV risk factors, most of those for total mortality remained statistically significant with hazard ratios for “more than 1 time” ranging from 1.26 to 1.59.Conclusions: Among young adults, having at least one violent episode in the past year with a spouse/lover or family member was significantly associated with incident CV events and total mortality. These associations were attenuated after adjusting for additional variables, such as smoking, as this high-risk behavior may lie in the causal pathway.