Effects of exposure to violence with a weapon during adolescence on adult hypertension.

Abstract: Objectives: To examine the longitudinal associations between exposure to violence with a weapon during the past year among adolescents and hypertension during adulthood, including the extent to which adult cardiovascular risk factors mediated the association. Methods: Secondary analysis of the National Longitudinal Study of Adolescent Health, 1994–2008. The sample included 3555 male and 4416 female participants who were aged 11–17 years at wave 1 (1994–1995). Participants were categorized as hypertensive if they had a mean systolic blood pressure of 140 mm Hg or higher or a mean diastolic pressure of 90 mm Hg or higher at wave 4 (2008). Witnessed violence with a weapon was defined as having seen a shooting or stabbing during the year before wave 1, whereas victim of violence with a weapon was defined as having been shot, cut, or stabbed or had a gun or knife drawn on them during the year before wave 1. Potential mediators of adult cardiovascular risk (wave 4) included body mass index, daily smoking, alcohol abuse, and depression. Results: Males who witnessed violence and females who were victims of violence in the year before wave 1 had an increased odds of hypertension at wave 4 compared with their unexposed peers (adjusted odds ratio, 1.45; 95% confidence interval, 1.003–2.10 and adjusted odds ratio, 1.72; 95% confidence interval, 1.04–2.84, respectively). The hypothesized adult cardiovascular risk mediators did not significantly attenuate the associations for either the male or female samples. Conclusions: Interventions addressing prior violence exposure are needed to promote adult cardiovascular health. [Copyright &y& Elsevier]