The association between intimate partner violence and cardiometabolic disease

Problem

Background: The World Health Organization estimates that intimate partner violence (IPV) affects 1 in 3 women. However, no cohort study has investigated the relationship between exposure to IPV and the development of cardiovascular disease (CVD), with few studies exploring hypertension (HTN) and type 2 diabetes mellitus (T2DM).

Objective: To identify if there is an association between IPV and the development of cardiometabolic disease.

Approach

Methods: Retrospective cohort study using routine data from ‘The Health Improvement Network’ Database between 1st January 1995-1st December 2017. 18,547 adult women exposed to IPV were compared to 74,188 unexposed women matched by age and gender. The main outcomes presented as adjusted incidence rate ratios (aIRR) were the risk of developing CVD, HTN and T2DM.

Findings

Results: 181 exposed women experienced a CVD event compared to 467 of the unexposed group. This related to an aIRR of 1.55 (CI 95% 1.29-1.85) with the association particularly significant with the development of ischaemic heart disease and stroke/trans-ischaemic attacks. 222 exposed women developed T2DM relating to an aIRR of 1.25 (CI 95% 1.07-1.46). We did not observe an association with HTN (aIRR 0.98; CI 95% 0.87-1.12). Following sensitivity analysis where individuals were matched for more lifestyle factors, these associations remained significant.

Consequences

Conclusions: There is an increased risk of developing CVD and T2DM in female survivors of IPV potentially independent of lifestyle choices. Considering the prevalence of IPV, clinicians should be aware of the disproportionally increased risk and therefore are encouraged to manage modifiable risk factors actively in this group.