Association of exposure to violence and risk of hypertension: Systematic review and meta-analysis

Public Health. 2025 Apr 21:105722. doi: 10.1016/j.puhe.2025.03.034. Online ahead of print.

ABSTRACT

OBJECTIVES: Hypertension is a major global health issue contributing to cardiovascular disease, stroke, and kidney failure. While traditional risk factors like age, diet, and genetics are well-known, the role of psychosocial stressors such as exposure to violence in hypertension development is less explored. This systematic review and meta-analysis assess the association between exposure to violence and the risk of hypertension.

STUDY DESIGN: Systematic review and meta analysis.

METHODS: A systematic search of Web of Science, PubMed, and Embase was conducted up to October 5, 2024. Studies reporting physical, sexual, and intimate partner violence (IPV) and their association with hypertension risk were included. A meta-analysis using random-effects models calculated pooled odds ratios (ORs) with 95 % confidence intervals (CIs), using R software (V 4.4).

RESULTS: Out of 564 articles screened, 11 studies with a total of 153,320 participants were included. The meta-analysis showed that individuals exposed to any violence had a 30.3 % increased risk of hypertension (OR: 1.303, 95 % CI: 1.200-1.416). Significant associations were found for physical violence (OR: 1.311, 95 % CI: 1.058-1.625) and sexual violence (OR: 1.412, 95 % CI: 1.239-1.609), while IPV showed a non-significant association (OR: 1.143, 95 % CI: 0.971-1.345). Heterogeneity was low (I² = 0 %), with no evidence of publication bias.

CONCLUSIONS: This review provides evidence that exposure to violence increases the risk of hypertension, indicating the importance of addressing violence as a public health issue. Healthcare providers should screen for violence history in hypertension management.

PMID:40263018 | DOI:10.1016/j.puhe.2025.03.034