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Early sexual experience and hypertension in US adults

results from the National Health and Nutrition Examination Survey 2001–2016

Ngueta, Gerarda,b,c; Ndjaboue, Ruthd,e

doi: 10.1097/HJH.0000000000001821

Objectives: We examined whether the early initiation of sexual activity is associated with hypertension in US adults, and whether the timing of first menstruation is meaningful in regard of this association. We also assessed the effect modification by ethnicity.

Methods: Using data from 2001 to 2016 National Health and Nutrition Examination Survey, we included 39 788 women. The association of age at the first sexual intercourse (FSI) and hypertension (SBP ≥ 130 mmHg or DBP ≥ 80 mmHg) was examined using multivariate logistic regression. Effect modification by ethnicity was assessed through a cross-product interaction term between age at FSI and ethnicity.

Results: Among women with FSI after their first menstruation, the odds of hypertension decrease by 20% [95% confidence interval (CI) −27 to −13%] in those who experienced FSI after 19 years of age, relative to those with FSI before 19 years of age. Ethnicity significantly modified the inverse association between age at FSI and hypertension (P value for interaction: 0.0003). Among non-Hispanic white, having FSI aged at least 19 years reduced the odds of hypertension by 34% (95% CI −41 to −27%). Turning to Latina women, the FSI before 19 years of age and before first menstruation resulted to a marked increase in the odds of hypertension [odds ratio = 1.38 (95% CI 1.15–1.65)]. In non-Hispanic black, the age at FSI was not linked to hypertension.

Conclusion: The FSI before 19 years of age is associated with hypertension during adulthood in US non-Hispanic white and Hispanic women, but not in non-Hispanic black.

aFaculté de Pharmacie, Université Laval

bInstitut National de Santé Publique du Québec, Bureau d’information et d’études en santé des populations

cInstitut universitaire de cardiologie et de pneumologie de Québec

dDépartement de médecine Sociale et Préventive, Faculté de médecine, Université Laval

eCentre de recherche du CHU de Québec, Unité de santé des populations et pratiques optimales en santé, Québec City, Québec, Canada

Correspondence to Gerard Ngueta, PhD, Institut National de Santé Publique du Québec, 945 Avenue Wolfe, Québec City, QC, Canada G1V 5B3. Tel: +1 418 650 5115; fax: +1 418 643 5099; e-mail:

Abbreviations: BP, blood pressure; CHD, coronary heart disease; FSI, first sexual intercourse; NHANES, National Health and Nutrition Examination Survey

Received 26 April, 2018

Revised 8 May, 2018

Accepted 11 May, 2018

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