Women who’ve been stalked face higher heart disease risk

By Stephen Beech

Stalking victims are up to 70% more likely to suffer a heart attack or stroke following their ordeal, according to new research.

Women who have been stalked are at "significantly" higher risk of heart disease, say scientists.

The American study showed that women who experienced being stalked or who obtained restraining orders were 41% more likely to develop heart disease over the following 20 years than women who had not been through the harrowing experience.

The risk of developing cardiovascular disease was "significantly" higher among women who obtained a restraining order for protection than those who had not requested one, according to the findings published in the journal Circulation.

Researchers say the link between stalking and cardiovascular disease may be due to psychological "distress" triggered by the ordeal.

Study author Dr. Rebecca Lawn said: “Although violence against women is common, and evidence has linked violence with consequences for women’s later heart health, it is still not widely recognized or routinely considered by health care professionals as a potential cardiovascular risk factor among women.

“We felt it was essential to look beyond traditional cardiovascular risk factors in women and strengthen our understanding of the relationship between underexplored types of violence and heart health.”

Around one in three women has been stalked at some point in their lives, according to official figures.

The research team analysed stalking, restraining orders, and heart disease or stroke among 66,270 American women ages 36 to 56 at enrolment in 2001 in a study which was part of a larger, ongoing survey of female nurses that began in 1989.

The women did not have cardiovascular disease in 2001, when they first shared whether they had experienced stalking or harassment, such as receiving unsolicited correspondence, that made them fearful.

The study also asked if participants had “ever taken out” a restraining order, which was considered a sign of severe violence.

The analysis found that, overall, nearly 12% of the women in the study reported that they had been stalked, while nearly 6% of them said they had obtained a restraining order.

Around 3% of all women studied reported new-onset heart disease or stroke during the 20-year study period.

Compared to women who had not been stalked, women who reported experiencing stalking were 41% more likely to have cardiovascular disease.

Women who had obtained a restraining order were 70% more likely to report cardiovascular disease compared to those who had not.

Similarly, women whose medical records confirmed heart attacks or strokes were more likely to have reported being stalked or obtaining a restraining order.

The increased risks for heart attack and stroke associated with stalking and restraining orders remained despite the existence of other self-reported cardiovascular risk factors, such as health and lifestyle behaviors, medications, health conditions, childhood abuse and symptoms of depression.

Dr. Lawn, a research associate in epidemiology at Harvard T.H. Chan School of Public Health in Boston, said: “Stalking is often seen as a form of violence that does not involve physical contact, which may make it seem less serious.

“However, our findings suggest stalking should not be minimized.

"Stalking can be chronic, and women often report making significant changes in response such as moving.”

The research team say the link between stalking and cardiovascular disease may be due to psychological distress, which may disrupt the nervous system, proper blood vessel function and other biological processes, although those potential mechanisms were not examined in detail in this study.

Dr. Lawn said more research, as well as training for health care professionals, is needed to understand the link between stalking or obtaining a restraining order and women’s cardiovascular health.

She added: “We also need to increase awareness about the potential health harms of experiencing violence and provide women with help and resources."

Dr. Lawn’s previous research linked sexual assault and workplace harassment to higher blood pressure in women.

Professor Harmony Reynolds, immediate past chair of the American Heart Association's Clinical Cardiology and Stroke Women’s Health Science Committee, said she was "surprised" by the strong association the study found between stalking and cardiovascular disease.

Reynold said: “A variety of stressful life experiences are known to increase the risk of cardiovascular disease, including adverse childhood experiences, financial stressors, grief and other experiences.

“People subjected to intimate partner violence face about a 30% higher risk of developing cardiovascular disease in the next few years compared to others.

"While this study shows a more moderate risk, given the long-time frame, it highlights how feeling unsafe can affect the body, in addition to the mind.”

She added: “Perhaps because it is our nature to re-think about things that happen to us, making us experience the situation over and over.

"However, social support may mitigate the effects of stress.

"It’s helpful to have people you can trust to talk with, whether they are family, friends, people in the community or professionals."