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.
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.
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.
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.