Experiences of Stalking and Obtaining a Restraining Order Are Associated With Onset of Cardiovascular Events in Women: A Prospective Analysis in the Nurses’ Health Study II
Bibliographic record
Abstract
BACKGROUND: Stalking is one of the most common forms of interpersonal violence, with nearly 1 in 3 women experiencing it in their lifetime. Restraining orders are a legal remedy aimed at protecting women who experience the most severe forms of stalking and interpersonal violence. Previous work has shown associations between experiences of violence and cardiovascular health among women, but little is known about the link between being stalked or obtaining a restraining order and risk of cardiovascular disease (CVD). METHODS: We examined whether being stalked or obtaining a restraining order (considered an indicator of severe violence) were associated with a greater risk of incident CVD over 20 years in the Nurses' Health Study II cohort. We conducted Cox proportional hazards regression models among women free of CVD in 2001 when their exposure status was ascertained (n=66 270). CVD events included self-reported myocardial infarction or stroke through 2021. Analyses were adjusted for a range of covariates. Secondary analyses included examining stroke and myocardial infarction separately and confirmed (through medical records) or corroborated cases of CVD as the outcomes. RESULTS: The mean (SD) age in our sample was 46.3 (4.7) years in 2001. Overall, 7721 women (11.7%) reported experiencing stalking, and 3686 women (5.6%) reported obtaining a restraining order. Over follow-up (median [interquartile range] 19.9 [19.5, 20.0] years), a total of 1879 women (2.8%) reported new-onset CVD. Compared with women who had not been stalked, women who reported experiencing stalking had an increased risk of self-reported incident CVD (hazard ratio, 1.41 [95% CI, 1.24-1.60]), adjusting for sociodemographic and childhood or family factors. Women who had, versus had not, obtained a restraining order also had an increased risk of self-reported incident CVD (adjusted hazard ratio, 1.70 [95% CI, 1.44-1.98]). Results were similar when considering self-reported myocardial infarction and stroke as separate outcomes and confirmed or corroborated CVD. Results were slightly attenuated but remained statistically significant when adjusted for health behaviors, medications, health conditions, childhood abuse, and depressive symptoms. CONCLUSIONS: Experiences of stalking and obtaining a restraining order are both associated with an increased risk of developing CVD in women. Common experiences of violence among women may affect cardiovascular health and warrant consideration alongside more traditional risk factors.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".