Sexual abuse and heart attacks

Many of us have a relative or a family friend who have had a myocardial infarction. A myocardial infarction, better known as a heart attack,
happens when blood flow to a section of the heart stops for so long that becomes damaged or dead. You’ve probably already heard about the common risk-promoting factors of heart attack, including obesity, smoking, and high cholesterol. But recent research has zoned in on another one.

In a 2012 U of T study, researcher Esme Fuller-Thomson and her team found a correlation between physical and sexual abuse in childhood and risk of heart attack.

Fuller-Thomson and her team examined a community sample of 5,095 males and 7,768 females from the United States. The participants were asked to report their history of myocardial infarction and how often anyone at least five years older than them had forced them to have sex. Any response greater than zero was simply recorded as a history of child abuse.

The results of the study showed that males who were sexually abused as children were nearly three times more likely than non-abused males to experience heart attacks in adulthood. The results were still consistent after experimenters controlled for traditional risk factors, such as age, race, smoking status, physical activity, and diabetes.

Strangely, though, there was no correlation between having a history of child abuse and heart attack in women.

Intrigued by these results, Fuller-Thomson and her team speculated that childhood sexual abuse may disrupt the hypothalamic-pituitary-adrenal axis in men.

The HPA axis is a set of interactions that take place between the hypothalamus, the pituitary glands, and the adrenal glands. The HPA axis directs a lot of everyday body functions, like digestion and the immune system. It is also involved in emotions, sexuality, and stress.

When the body is exposed to extreme stress, as it is during childhood abuse, the HPA axis increases production of the stress hormone, cortisol. In previous studies, high levels of cortisol were associated with heart attacks in men.

Still curious about why this connection was not seen in women, Fuller-Thomson and her team speculated that different behaviours in women may “protect” them from heart
attacks in adulthood. Women, they said, are more likely to seek support and counselling after childhood sexual abuse. The help they get may have relieved the stress that produces high levels of cortisol.

Fuller-Thomspon’s study, however, has its limitations. For example, the team did not verify all reports of heart attack with the subjects’ medical records. Participants who reported they had not experienced heart attacks may actually have, but may not have felt comfortable sharing this information.

Also, the study did not collect information about biological risk factors, such as level of serum cholesterol, that could have influenced the participants’ predisposition to heart attacks.

Nevertheless, the study was significant. Using a large sample size, the authors showed that childhood
sexual abuse was associated with risk for myocardial infarctions in males. Previous research shows that childhood abuse affects adult mental health as well as physical health. One possible response from our healthcare system might be to acknowledge the findings and provide preventative counselling to those who have suffered abuse.

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