Exploring psychosocial risk factors for stroke in young women exposed to domestic violence

Abstract

Background and purpose: The incidence of stroke is projected to increase worldwide and reduction of risk of the first stroke is therefore important. First stroke in young women often poses a diagnostic challenge but it has been suggested the risk is associated with hightened exposure to domestic abuse. This UK study was conducted to determine the incidence and examine the predisposing risk factors for early stroke in young women suffering domestic violence. The effect of a range of psychosocial variables and health behaviours on the incidence of strokes in young women in an abusive relationship is assessed. Methods: A cross-sectional survey collected information by self-report questionnaires on 237 women aged 18-56 exposed to domestic violence. The survey instrument measured the negative consequences of abuse and comprised demographic information, health status assessment, physical health illnesses and history of abuse. The GHQ-12 a stress measure was employed to gauge the effects of exposure to threatening life events. Correlational analyses and factor analysis were performed. Data was matched for women aged 20-44 with the average annual incidence rates of risk of first stroke in young women according to the Oxford Vascular stroke project register Results and conclusions: Unsurprisingly, a high incidence of depression was found in this study even when the majority of women were on medication. A number of high-risk behaviours were also associated with strangulation, alongside the physical trauma. The incidence of first stroke found in the study was 5 cases classified as 3 ischemic and 2 hemorrhagic strokes, such a high frequency has not previously been described in the research literature. According to Oxford data the incidence of stroke among women aged 20-44 in the UK is 0.14/1000 per year. Stroke sub-type incidence rates were found to be 10 fold increased risk for ischemic and 15 fold increased risk for hemorrhagic stroke compared with the matched control. Trauma was found to be the most common predisposing factor to stroke other reported risk factors to increase the risk of stroke included poor health profile, migraine, and heavy alcohol consumption. These incidence rates may be underestimates as a consequence of women not attending for medical care, hence tragically managing stroke-related symptoms in the home. However, due to the small numbers of stroke victims the results must be viewed with caution.