Cumulative Lifetime Violence, Gender Role Conflict, and Cardiovascular Disease Risk in Eastern Canadian Men.

Abstract

Despite violence being a chronic stressor that negatively affects health through allostatic overload and potentially harmful coping behaviors, the relationship between cumulative lifetime violence severity (CLVS) and cardiovascular disease (CVD) risk in men has received little attention and the role of gender has not been considered. Using survey and health assessment data from a community sample of 177 of eastern Canadian men with CLVS as target and/or perpetrator, we developed a profile of CVD risk measured by the Framingham 30-year risk score. We tested the hypothesis that CLVS measured by the CLVS-44 scale has direct and specific indirect effects through gender role conflict (GRC) on 30-year CVD risk using parallel multiple mediation analysis. Overall, the full sample had 30-year risk scores 1.5 times higher than their age-based Framingham reference normal risk scores. Men classified as having elevated 30-year CVD risk (n = 77) had risk scores 1.7 times higher than reference normal. Although the direct effects of CLVS on 30-year CVD risk were not significant, indirect effects of CLVS through GRC, specifically Restrictive Affectionate Behavior Between Men, were significant. These novel results reinforce the critical role of chronic toxic stress, particularly from CLVS but also from GRC, in influencing CVD risk. Our findings highlight the need for providers to consider CLVS and GRC as potential antecedents to CVD and to routinely use trauma- and violence-informed approaches in the care of men.