In the U.S., approximately 20 people a minute experience physical or mental abuse from an intimate partner (aka intimate partner violence). That staggering statistic is not only horrifying, but it may also contain clues to America’s heart disease epidemic. In addition to the risk of immediate physical and mental harm, a new study found that the emotional scars left by intimate partner violence may have severe repercussions for heart health, decades later.
Experts in This Article
What the research says
Study results released by the American Heart Association uncovered disturbing connections between mental or physical abuse in a romantic relationship in young adulthood, and the occurrence of cardiovascular events, including heart attacks and strokes, in middle age.
Even if you try to shrug them off, violent or hurtful events can continue to harm you, affecting your well-being for years. According to the Centers for Disease Control and Prevention (CDC), intimate partner violence is a broad term that includes physical, sexual, or psychological aggression perpetrated by a current or former intimate partner. In-person and electronic stalking are included in that definition.
According to the study, intimate partner violence can increase your risk for cardiovascular disease, even if you’ve extricated yourself from the situation. No matter what your gender, violence, threats, and manipulative gaslighting can all intrude on your physical health and may, in time, adversely affect your heart.
These findings came from participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, which began in 1983. The CARDIA study’s goal is to identify heart disease risk factors that manifest in young adulthood.
For the sub-study on intimate partner violence, researchers analyzed cardiovascular events in CARDIA study participants who experienced more than one violent episode during or after an intimate relationship. Childhood experiences of domestic violence or abuse were not included in the data.
No amount of violence is okay. However, the study found that long-term or ongoing abuse was worse for heart health than a single or short-term encounter. “A dose-response relationship was found between intimate partner violence and poor cardiovascular health. More violence equated to worse outcomes,” says Randi Foraker, PhD, MA, FAHA, a spokesperson for the AHA sub-study on intimate violence.
How intimate partner violence may affect your heart
It’s understandable that dealing with violence from a loved one could lead to lifestyle choices that adversely affect heart health. Study participants self-reported higher-than-average alcohol and cigarette use, as well as high rates of depression.
Drinking and smoking are hardly heart-healthy but don’t tell the whole story. According to Dr. Foraker, a causal relationship between acts of intimate partner violence and poor heart health was established by the research. “ Lifestyle factors like drinking and smoking were accounted for in the study analysis. These self-reported measures are often underreported, so it’s hard to know what contribution those behaviors have along the causal pathway. However, as a potential risk factor, intimate partner violence may provide a biological basis for increased inflammation via the stress pathways of the body,” says Dr. Foraker.
Ah yes, inflammation and stress. The pesky duo can contribute to everything from acne breakouts to chronic diseases.
It’s a no-brainer that dealing with violence can cause stress. Prolonged, sustained stress increases the production of cortisol, the fight-or-flight stress hormone. When cortisol levels are high, inflammation increases, the heart beats faster, and blood pressure rises. Over time, cortisol secretion and inflammation become the body’s standard response to chronic stress. Heart attacks, heart disease, and stroke may all follow.
How to reduce your risk of intimate partner violence
First things first. If you’re in a relationship that is violent, abusive, or hurtful, think about creating a plan to extricate yourself, even if you love the person. Experts say that violent episodes are rarely one-and-done unless an intervention occurs. Violence can also escalate in scale over time.
“There can be a grooming aspect to violence that’s coming. This can include isolating you from others, or controlling what you can and can’t do. Significant shifts in independence are a huge sign of trouble ahead,” says Emily Eckstein, PsyD, LMFT, the vice president of regional operations for Lightfully Behavioral Health in Beverly Hills.
Dr. Eckstein often works with people in abusive relationships who aren’t ready to leave. Children, finances, and psychological readiness can all play a role. So can fears about not being believed. “If something feels wrong, identify people you trust who will shelter you or help you leave when you’re ready. This can be part of your safety plan,” she says.
Creating a safety plan to use if you need to can be crucial. Your plan can include medical providers or spiritual leaders in your community of faith. ”Identifying trustworthy, safe people who will believe and take care of you, as well as safe places where you can go, is vital. Your safety plan can include calling an abuse hotline or dialing 911. It doesn’t have to be a friend or a family member. It just has to be someone you can trust,” adds Dr. Eckstein.
Dr. Eckstein notes that personal levels of resiliency can play a role in someone’s ability to leave a challenging situation, and cope with it later. Resiliency can be shaped in large part by your environment and opportunities.
It can be harder to leave an abusive relationship if you’re living in challenging circumstances or poverty. For that reason, Elizabeth A. Jackson, MD, MPH, FAHA, director of the cardiovascular outcomes and effectiveness research program at UAB Medicine in Birmingham, AL believes that prevention can be part of the cure. “If we don’t treat people and communities holistically, we’re missing risk factors that can damage cardiovascular health. We can’t just treat blood pressure and lipid levels. We also have to think about helping people reduce stressors, like intimate partner violence.”
How to reduce cardiovascular risk caused by intimate partner violence
Whether your relationship occurred two months or twenty years ago, you can reduce its impact on your life and health.
“Ample evidence from hundreds of thousands of people who have participated in trial studies make it clear that healthy blood pressure is essential for staving off heart disease. It’s important that people have good blood pressure and if they don’t, we must treat it. Whether you have violence in your past or not, this is imperative for heart health,” says Dr. Jackson.
For some people, working with a therapist will be essential. “The role of therapy was not addressed in the sub-study on intimate partner violence. However, my opinion is that therapy could be highly beneficial for mitigating intermediating risk factors, like decreasing dependence on alcohol. It can also help people acquire tools to better manage stress, which could have a significant impact,” says Dr. Foraker.
No matter how you choose to address your past, remember that risk factors are not fate. You can’t change what happened or wish it away. You can, however, control your current choices. Eating heart-healthy food and moving your body is, of course, highly beneficial. Stressbusters like meditation and yoga can also bring your blood pressure down and your mood up on a daily basis.
Just as importantly, keep the people who have your back close to you – and be willing to listen if they notice something’s wrong. “So often, parents will mention having concerns about their child that they didn’t act upon. They may have noticed that their teenage daughter stopped doing the things she loved and started shying away from old friends. Having people in your life who will share their concerns if they think something wrong can help block intimate partner violence,” says Dr. Eckstein.
No matter how it feels, or where you are in this journey, the power to a healthy heart—and to healing—is within your control.
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