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Men who experienced childhood sexual abuse are three times more likely to have a heart attack than all other men, researchers at the University of Toronto have found.

Their study, published online this week in the journal Child Abuse & Neglect, found no association between childhood sexual abuse and heart attacks among women.

“We had expected that the abuse-heart attack link would be due to unhealthy behaviours 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,” says lead author Esme Fuller-Thomson, professor and Sandra Rotman Chair at University of Toronto’s Factor-Inwentash Faculty of Social Work. “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.”

Investigators examined gender-specific differences in a representative sample of 5095 men and 7768 women aged 18 and older, 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.

“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,” says Brennenstuhl. “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, 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,” says Fuller-Thomson, adding cortisol is also implicated in the development of cardiovascular diseases.