Compared with women who were not molested or raped as children or teens, women who reported:
• Repeated episodes of forced sex in childhood or adolescence had a 62% higher risk of cardiovascular disease as adults.
• Severe physical abuse in childhood or adolescence had a 45% increased risk of cardiovascular events.
Mild to moderate physical or sexual abuse was not associated with increased risk.
“The single biggest factor explaining the link between severe child abuse and adult cardiovascular disease was the tendency of abused girls to have gained more weight throughout adolescence and into adulthood,” said Janet Rich-Edwards, ScD, Associate Professor in the Department of Medicine at Brigham and Women’s Hospital in Boston.
The researchers studied the associations of child and adolescent abuse with confirmed cardiovascular disease events such as heart attacks and strokes from 1989 to 2007 among 67,102 women in the Nurses’ Health Study II. Eleven percent reported forced sexual activity during childhood and adolescence, and 9% reported severe physical abuse.
Associations of severe abuse were stronger for stroke than for heart attack. Risk factors such as adult BMI, smoking, alcohol use, hypertension, and diabetes accounted for 41% of the association of severe physical abuse and 37% of the association of forced sex with cardiovascular disease events. “These traditional cardiovascular risk factors explain about 40% of the association we see between abuse and cardiovascular disease, which suggests that other factors may play an important role, such as increased stress reactivity among people with a history of abuse,” said Dr. Rich-Edwards.
The study included primarily white nurses, so further research should be done with different socio-demographic groups, she noted.
“Women who experience abuse need to take special care of their physical and emotional well-being to reduce their risk of chronic disease,” Dr. Rich-Edwards said. “Primary care health professionals need to consider childhood abuse histories of women as they transition into adulthood, but to help the health professionals prevent cardiovascular disease among women with a history of abuse, we need to learn more about specific psychological, lifestyle, and medical interventions to improve the health of abuse survivors.”
Wearable Defibrillator Can Prevent Death in Patients With Arrhythmias
A wearable defibrillator can prevent sudden death in people with dangerous heart arrhythmias, according to researchers.
Wearable cardioverter defibrillators are used by people who may be at higher risk for sudden cardiac arrest, including those who have weakened heart function, are awaiting cardiac transplant, or have a condition that prevents or delays them from receiving an implanted defibrillator.
The device monitors heart rhythm, emits alarms if a serious arrhythmia occurs, delivers an electric shock to the heart if needed, and alerts bystanders to help if the heart’s electrical activity has stopped.
About 5,000 patients are using wearable defibrillators at any one time, usually for about 60 days, said Vincent N. Mosesso Jr, MD, Professor of Emergency Medicine at the University of Pittsburgh School of Medicine and principal investigator of the study.
“In these patients, the wearable defibrillator is a noninvasive ‘insurance policy’ against sudden arrest during their vulnerable period,” he said.
Researchers gathered heart rhythm records and calls about shocks from a registry of 14,475 patients with wearable defibrillators listed from 2007 through 2009. Of those, 185 (about 1%) received an appropriate shock and 91.6% survived one or more episodes of ventricular fibrillation or ventricular tachycardia, the most common abnormal rhythms during cardiac arrest.
Wearable defibrillators delivered 223 inappropriate shocks to 213 people who were not experiencing ventricular fibrillation or ventricular tachycardia. However, no one died as a result. The researchers attribute the inappropriate shocks to signal noise, rapid non-VT rhythms, and rhythm misinterpretation.
About 7% of people in the United States who have sudden cardiac arrest outside the hospital survive to hospital discharge, and about 21% who have it in the hospital survive to discharge.
“This study confirms the effectiveness of very early defibrillation as therapy for sudden cardiac arrest in high-risk patients when delivered by a wearable defibrillator,” Dr. Mosesso said. “These defibrillators provide patients the critical advantage of not having to wait for a bystander or emergency responder to recognize the cardiac arrest and use an automated external defibrillator or manual defibrillator—both of which can lead to delays in treatment and markedly worse survival rates.