Study Background and Disease Burden
Interpersonal violence represents a pervasive public health concern worldwide, disproportionately affecting women. Among various forms of violence, stalking is notable for its high prevalence, with nearly one-third of women experiencing it during their lifetime. This form of persistent harassment can result in psychological distress, physical harm, and substantial disruption to daily life. Restraining orders, legal instruments used to protect individuals from severe stalking or interpersonal violence, reflect cases typically involving heightened risk or severity. While the psychological consequences of stalking have been extensively documented, less is understood about its impact on physical health, particularly cardiovascular disease (CVD).
Cardiovascular disease remains the leading cause of morbidity and mortality globally, with substantial disease burden in women. Traditional risk factors for CVD include hypertension, diabetes, smoking, and dyslipidemia. Increasingly, psychosocial stressors and trauma-related exposures, such as intimate partner violence, have been recognized as influential contributors to CVD risk. The physiological mechanisms linking trauma and cardiovascular health likely involve chronic systemic inflammation, dysregulation of the autonomic nervous system, hormonal imbalances, and adverse health behaviors. Yet, the specific relationship between stalking—with or without the intervention of obtaining a restraining order—and long-term cardiovascular outcomes has not been well characterized prior to this study.
