Association between childhood sexual abuse and heart attacks among men

Men who experienced childhood sexual abuse are three times more likely to have a heart attack than men who were not sexually abused as children, according to a new study from researchers at the University of Toronto. The researchers found no association between childhood sexual abuse and heart attacks among women.

In a paper published online this week in the journal Child Abuse & Neglect, investigators examined gender-specific differences in a representative sample of 5095 men and 7768 women aged 18 and over, drawn from the Center for Disease Control's 2010 Behavioral Risk Factor Surveillance Survey. A total of 57 men and 154 women reported being sexually abused by someone close to them before they turned 18 and 377 men and 285 women said that a doctor, nurse or other health professional had diagnosed them with a heart attack or myocardial infarction. The study was co-authored by four graduate students at the University of Toronto, Raluca Bejan, John Hunter, Tamara Grundland and Sarah Brennenstuhl.

"Men who reported they were sexually abused during childhood were particularly vulnerable to having a heart attack later in life," says lead author Esme Fuller-Thomson, Professor and Sandra Rotman Chair at University of Toronto's Factor-Inwentash Faculty of Social Work. "We had expected that the abuse-heart attack link would be due to unhealthy behaviors in sexual abuse survivors, such as higher rates of alcohol use or smoking, or increased levels of general stress and poverty in adulthood when compared to non-abused males. However, we adjusted statistically for 15 potential risk factors for heart attack, including age, race, obesity, smoking, physical inactivity, diabetes mellitus, education level and household income, and still found a three-fold risk of heart attack."

Co-author and PhD candidate Sarah Brennenstuhl notes that, "It is unclear why sexually abused men, but not women, experienced higher odds of heart attack; however, the results suggest that the pathways linking childhood sexual abuse to physical health outcomes in later life may be gender-specific. For example, it is possible that females adopt different coping strategies than males as women are more likely to get the support and counselling needed to deal with their sexual abuse."

"These findings need to be replicated in future scientific studies before we can say anything definitive about this link," cautions Fuller-Thomson. "But if other researchers find a similar association, one possible explanation is that adverse child experiences become biologically embedded in the way individuals react to stress throughout their life, particularly with respect to the production of cortisol, the hormone associated with the "fight-or-flight" response. Cortisol is also implicated in the development of cardiovascular diseases.