Women who have been stalked or obtained restraining orders face significantly higher risks of heart disease and stroke over the long term, new research has found.
Published in the journal Circulation, the study followed more than 66,000 women over 20 years and found that those who reported being stalked by a current or former partner – or other people – were 41 per cent more likely to develop cardiovascular disease than those who did not report stalking.
The risk was even higher for women who had obtained a restraining order, with a 70 per cent greater likelihood of heart disease or stroke.
“To many people, stalking doesn’t seem to be such a serious experience, as it often does not involve physical contact. But stalking has profound psychological consequences that can have physical implications,” said Karestan Koenen, the study's senior author and a professor of psychiatric epidemiology at Harvard University in the US.
The findings underscore that "common, non-contact forms of violence against women are health hazards and need to be considered as such, just like we consider smoking or poor diet," Koenen added.
Stalking affects roughly one in three women and one in six men over the course of their lives, according to the US Centers for Disease Control and Prevention (CDC). In the European Union, that figure is 18.5 per cent, with rates ranging from 8.5 per cent in Lithuania to 32.4 per cent in Slovakia, EU data shows.
Stalking involves repeated unwanted behaviours, such as following, spying, uninvited visits, or online harassment.
Yet the study highlights that stalking is rarely addressed in medical research, despite the profound psychological trauma it can cause and its potential physical health impacts
The study analysed data from a long-running survey of female nurses in the United States, collecting information on their stalking history in 2001 and following participants through 2021.
At the beginning of the study, none of the women had cardiovascular disease. Nearly 12 per cent reported having been stalked, and almost 6 per cent said they had obtained a restraining order at some point.
Heart disease and stroke were self-reported and verified through medical records. Over the next two decades, about 3 per cent of women developed cardiovascular disease, with significantly higher risks for those who had been stalked or obtained restraining orders.
Calls for improved screening and support in healthcare
The study authors suggest that psychological distress from stalking may disrupt the nervous system, impair blood vessel function, and alter other biological mechanisms – potential pathways linking violence with cardiovascular harm.
However, additional studies would be needed to better understand the link.
Notably, most participants in this study were non-Hispanic white nurses, meaning the findings may not fully capture the experiences of women overall. Previous studies have shown that stalking and violence disproportionately impact women from minority ethnic groups and lower-income communities.
Despite these limitations, the study authors said their findings indicate more needs be done to address violence against women.
"In health care settings, we need to improve screening for stalking and other forms of violence and provide resources for women to protect themselves," Koenen said.
"And zooming out further, on a broad public health level, we need to do better in addressing and preventing the root causes of violence against women," she added.
