Sexual Assault, Harassment Linked to Greater Risk of High Blood Pressure in Women

Woman checking blood pressure.

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Key Takeaways

  • Sexual assault and workplace harassment are common and may increase the long-term risk of hypertension in women, according to a study.
  • The study did not find an increased risk of hypertension in women who had a history of other types of traumatic experiences or events.
  • Reducing sexual violence against women could be an effective way to improve women’s long-term cardiovascular health.

New research is shining a light on how experiences of sexual assault and harassment can have damaging effects on cardiovascular health. 

A February 2022 study, published in the Journal of the American Heart Association, found that women who have experienced sexual assault, workplace sexual harassment, or both may be at higher long-term risk of developing high blood pressure, or hypertension, compared to women who have no history of these types of trauma.

Researchers from Harvard T.H. Chan School of Public Health analyzed data for seven years starting with a 2008 follow-up of the Nurses’ Health Study II, one of the largest prospective studies that look into the risk factors for major chronic diseases in women. 

More than 33,000 participants—mostly White middle-aged women between the ages of 43 to 64—with no history of cardiovascular disease or use of medication for high blood pressure reported in 2008 whether they had experienced sexual assault at work or other unwanted sexual contacts, and exposure to other traumas, including accident, disaster or death of a loved one.

The authors said women were asked whether they had ever experienced sexual harassment at work that was either physical or verbal and whether they had ever been made or pressured into having some type of unwanted sexual contact. The study captured a broad range of sexual harassment experiences within the workplace, as well as sexual assault that could have happened within or outside of established partnerships.

Researchers found that the occurrence of sexual assault appeared to be common—23% of women said they had experienced sexual assault at some point in their life, 12% reported workplace sexual harassment, and 6% said they had experienced both.

In a 2015 follow-up of the group, about 21% of the women self-reported they had developed hypertension.

And women who reported having experienced both sexual assault and workplace sexual harassment had a 21% increased risk of developing high blood pressure. Women who said they experienced workplace sexual harassment had a 15% higher risk and women who reported sexual assault had an 11% higher risk of hypertension compared to women with no experience of these types of trauma.

“Sexual assault and workplace sexual harassment are common experiences among women that are not currently appreciated as risk factors for their long-term cardiovascular health,” Rebecca Lawn, PhD, lead researcher at the Harvard T.C. Chan School of Public Health, told Verywell in an email. “Given that hypertension is an important risk factor for cardiovascular disease, the leading cause of death of women, our results may help early identification of factors that influence women’s cardiovascular health long-term.” 

Lawn added the study only included mid-life women and does not apply to other age or gender groups. Future studies will be needed to examine how the findings can apply across other identities.

While this study focused on women, sexual violence affects many people and not everyone equally. In the U.S. alone, over 400,000 people experience rape or sexual assault each year according to estimates. And transgender, genderqueer, and nonconforming students face a higher risk.

Why Is There a Higher Risk?

According to Lawn, there could be several explanations for why women who experience sexual violence are more likely to develop hypertension.

She noted that oftentimes stress follows and is a result of sexual violence. That stress can lead to excessive activation of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system, and poorer endothelial function—cells that control blood clotting and immune function—which can, in turn, affect health.

Overstimulation of the HPA axis can lead to mood disorders such as depression and is linked to anxiety, mood swings, and irritability. Increased activity in the sympathetic nervous system can also lead to increased heart rate, respiration, and blood pressure.

Nieca Goldberg, MD, a national volunteer expert for the American Heart Association and a clinical associate professor at NYU Grossman School of Medicine, who was not a part of the study, told Verywell in an email that sexual assault is associated with both physical and emotional trauma. These experiences can lead to stress, anger, depression, social isolation, and negative emotions which all contribute to increased high blood pressure.

“The release of stress hormones like cortisol and epinephrine raises blood pressure,” Goldberg said. “Also experiencing these emotions make it difficult to follow healthy lifestyles such as a healthy diet, exercise, or quit smoking.”

Goldberg added that high blood pressure is a major risk factor since it can lead to an increased risk of heart attack, stroke, heart failure, kidney disease, and eye disease.

Do Other Traumatic Experiences Play A Role?

Lawn said the findings of the study for sexual assault and workplace sexual harassment are in line with several recent studies showing that other forms of violence against women, including intimate partner violence, are associated with long-term physical health consequences.

However, in the study researchers did not find any association of increased risk of hypertension among women who had a history of other types of trauma.

“We did not see a consistent relationship between other traumas (in the absence of sexual assault or workplace harassment) and hypertension, suggesting that increased risk of hypertension may be specific and related to trauma type, frequency or severity,” Lawn said.

What This Means For You

Preventing violence against women can improve women’s cardiovascular health. If you have experienced sexual assault or violence, seeking therapy and professional counseling can help with emotional trauma. A healthy diet and daily exercise can help treat high blood pressure.

Looking Forward

If you or someone you know has experienced sexual assault or harassment, Goldberg recommends seeking therapy or professional counseling, which can help address emotional trauma.

Healthcare providers should also ask if an individual has experienced sexual assault or harassment to assist them in finding counseling and additional resources that can help prevent negative health conditions.

“Preventing violence against women may also benefit women’s cardiovascular health,” Lawn said. “These findings also suggest that screening women who are at risk of cardiovascular health problems for experiences of sexual assault and workplace harassment and addressing any health consequences may be beneficial if implemented in routine healthcare.”

Rebecca Thurston, PhD, study coauthor and professor of psychiatry at the University of Pittsburgh, told Verywell in an email more work needs to be done to determine any causal relationship between sexual violence and hypertension, or whether treating women for their trauma will reduce their blood pressure.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lawn RB, Nishimi KM, Sumner JA, et al. Sexual violence and risk of hypertension in women in the Nurses’ Health Study II: a 7‐year prospective analysisJ Am Heart Assoc. 2022;11(5):e023015. doi:10.1161/jaha.121.023015

  2. Rape, Abuse & Incest National Network. Victims of sexual violence: statistics.

  3. Russell AL, Tasker JG, Lucion AB, et al. Factors promoting vulnerability to dysregulated stress reactivity and stress‐related disease. J Neuroendocrinol. 2018;30(10):e12641. doi:10.1111/jne.12641

  4. O’Connor DB, Thayer JF, Vedhara K. Stress and health: a review of psychobiological processes. Annu Rev Psychol. 2021;72(1):663-688. doi:10.1146/annurev-psych-062520-122331

By Alyssa Hui
Alyssa Hui is a St. Louis-based health and science news writer. She was the 2020 recipient of the Midwest Broadcast Journalists Association Jack Shelley Award.