A new study published in the American Heart Association’s journal Circulation has found that women who reported being stalked or who obtained a restraining order faced a significantly higher risk of heart attack and stroke in later life. The research highlights an under-recognised link between experiences of violence and women’s cardiovascular health, urging healthcare professionals to consider such factors alongside more traditional risks. Lead author Rebecca B. Lawn, Ph.D., from Harvard T.H. Chan School of Public Health and the University of British Columbia, emphasised the importance of moving beyond conventional risk factors to examine how underexplored forms of violence may affect long-term health.
The study analysed data from over 66,000 participants in the Nurses’ Health Study II, tracking women aged 36 to 56 from 2001 to 2021. None of the women had cardiovascular disease at the start of the study. Researchers collected self-reported data on stalking experiences and restraining orders, then compared these against medical outcomes such as heart attacks and strokes. Overall, nearly 12% of women reported stalking experiences, while almost 6% reported having obtained a restraining order—considered a marker of severe violence.
Findings revealed that women who reported stalking were 41% more likely to develop cardiovascular disease compared to those who had not, while those with restraining orders faced a 70% higher risk. Roughly 3% of participants developed new-onset heart disease or stroke over the study’s 20-year period. These associations remained even after accounting for conventional risk factors such as lifestyle, medication, health conditions, depression, and childhood abuse. The results suggest that experiences of stalking and harassment can exert long-term health consequences that extend beyond psychological harm.
The study underscores the chronic and often underestimated impact of stalking. “Stalking is often seen as less serious because it does not involve physical contact,” Lawn noted. “However, it can be persistent and disruptive, often forcing women to make significant changes such as moving house.” Other experts, such as Dr Harmony R. Reynolds from NYU Grossman School of Medicine, stressed that feeling unsafe can be profoundly damaging to cardiovascular health, echoing evidence that stress, trauma, and intimate partner violence raise disease risk over time.
Researchers suggest that the connection between stalking, restraining orders, and cardiovascular disease may be rooted in psychological distress, which disrupts biological processes such as nervous system regulation and blood vessel function. While the precise mechanisms were not thoroughly examined in this study, the findings align with previous research linking sexual assault and workplace harassment to higher blood pressure. They highlight the need for greater awareness, prevention strategies, and support systems for women who have endured violence.
Despite its strengths, the study had limitations. Most participants were non-Hispanic white women and registered nurses, which means the results may not apply to more diverse populations. Moreover, data on stalking and restraining orders relied on self-reports, though health outcomes were confirmed with medical records. Even so, the evidence reinforces the urgency of training healthcare providers to recognise violence as a potential cardiovascular risk factor and to connect affected women with appropriate resources and support.
More information: Rebecca B. Lawn et al, Experiences of Stalking and Obtaining a Restraining Order Are Associated With Onset of Cardiovascular Events in Women: A Prospective Analysis in the Nurses’ Health Study II, Circulation. DOI: 10.1161/CIRCULATIONAHA.124.073592
Journal information: Circulation Provided by American Heart Association
