title: Abuse and subclinical cardiovascular disease among midlife women: the study of women's health across the nation.
abstract: OBJECTIVE
  Some evidence suggests that abuse may be related to cardiovascular disease (CVD) risk among women. However, this relation has largely been addressed using self-reported measures of CVD. We tested whether a history of abuse was related to subclinical CVD among midlife women without clinical CVD.
  
  
  METHODS
  The Study of Women's Health Across the Nation (SWAN) is a longitudinal cohort study of women transitioning through the menopause. One thousand four hundred two white, black, Hispanic, and Chinese SWAN participants completed measures of childhood and adult physical and sexual abuse, underwent a blood draw, completed physical measures, and underwent a carotid artery ultrasound at SWAN study visit 12. Associations between abuse and intima media thickness and plaque were tested in linear and multinomial logistic regression models controlling for age, site, race/ethnicity, financial strain, education, body mass index, lipids, blood pressure, measures of insulin resistance, smoking, alcohol use, physical activity, and medication use.
  
  
  RESULTS
  Findings indicated that a history of childhood sexual abuse was associated with higher intima media thickness controlling for standard CVD risk factors and other confounders (β=0.022; SE=0.010; P<0.05; adjusted mean childhood sexual abuse: 0.800 mm versus no childhood sexual abuse: 0.782 mm).
  
  
  CONCLUSIONS
  Childhood sexual abuse was associated with higher intima media thickness controlling for CVD risk factors and other confounders. These findings indicate the importance of considering the potential impact of early-life stressors on women's later cardiovascular health.
authors.affiliation: From the Departments of Psychiatry (R.C.T., K.A.M.) and Neurological Surgery (Y.C.), University of Pittsburgh School of Medicine, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA (R.C.T., J.T.B., K.A.M.); Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (C.A.D.); Department of Epidemiology, Henry F. Vaughn School of Public Health, University of Michigan, Ann Arbor (S.D.H.); and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL (I.J.). thurstonrc@upmc.edu.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Thurston
authors.affiliation: From the Departments of Psychiatry (R.C.T., K.A.M.) and Neurological Surgery (Y.C.), University of Pittsburgh School of Medicine, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA (R.C.T., J.T.B., K.A.M.); Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (C.A.D.); Department of Epidemiology, Henry F. Vaughn School of Public Health, University of Michigan, Ann Arbor (S.D.H.); and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL (I.J.).
authors.forename: Yuefang
authors.initials: Y
authors.lastname: Chang
authors.affiliation: From the Departments of Psychiatry (R.C.T., K.A.M.) and Neurological Surgery (Y.C.), University of Pittsburgh School of Medicine, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA (R.C.T., J.T.B., K.A.M.); Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (C.A.D.); Department of Epidemiology, Henry F. Vaughn School of Public Health, University of Michigan, Ann Arbor (S.D.H.); and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL (I.J.).
authors.forename: Carol A
authors.initials: CA
authors.lastname: Derby
authors.affiliation: From the Departments of Psychiatry (R.C.T., K.A.M.) and Neurological Surgery (Y.C.), University of Pittsburgh School of Medicine, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA (R.C.T., J.T.B., K.A.M.); Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (C.A.D.); Department of Epidemiology, Henry F. Vaughn School of Public Health, University of Michigan, Ann Arbor (S.D.H.); and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL (I.J.).
authors.forename: Joyce T
authors.initials: JT
authors.lastname: Bromberger
authors.affiliation: From the Departments of Psychiatry (R.C.T., K.A.M.) and Neurological Surgery (Y.C.), University of Pittsburgh School of Medicine, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA (R.C.T., J.T.B., K.A.M.); Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (C.A.D.); Department of Epidemiology, Henry F. Vaughn School of Public Health, University of Michigan, Ann Arbor (S.D.H.); and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL (I.J.).
authors.forename: Sioban D
authors.initials: SD
authors.lastname: Harlow
authors.affiliation: From the Departments of Psychiatry (R.C.T., K.A.M.) and Neurological Surgery (Y.C.), University of Pittsburgh School of Medicine, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA (R.C.T., J.T.B., K.A.M.); Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (C.A.D.); Department of Epidemiology, Henry F. Vaughn School of Public Health, University of Michigan, Ann Arbor (S.D.H.); and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL (I.J.).
authors.forename: Imke
authors.initials: I
authors.lastname: Janssen
authors.affiliation: From the Departments of Psychiatry (R.C.T., K.A.M.) and Neurological Surgery (Y.C.), University of Pittsburgh School of Medicine, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA (R.C.T., J.T.B., K.A.M.); Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (C.A.D.); Department of Epidemiology, Henry F. Vaughn School of Public Health, University of Michigan, Ann Arbor (S.D.H.); and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL (I.J.).
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
mesh_terms: D000293:Adolescent; D054523:Adult Survivors of Child Abuse; D001741:Black or African American; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D012307:Risk Factors; D044465:White People; D016387:Women's Health
keywords: atherosclerosis; carotid intima media thickness; child abuse; menopause; women