Sexual abuse as a child increases a woman's risk of developing early signs of artery disease, a study has found.
Scientists linked a history of sexual abuse with inner lining thickening of the carotid artery carrying blood to the brain.
The condition might indicate early atherosclerosis, or narrowing and hardening of the arteries, which increases the likelihood of heart attacks and strokes.
Of the 1,400 American women aged 42 to 52 studied, 16% reported being sexually abused during childhood. The proportion was as high as 20% among African-Americans.
Only sexual abuse, not physical abuse, was linked to higher artery thickness. Researchers believe stress could be the explanation.
Lead scientist Dr Rebecca Thurston, from the University of Pittsburgh, said: "These study findings indicate the importance of considering early life stressors on women's later cardiovascular health.
"Awareness of the long-term mental and physical consequences of sexual abuse in childhood needs to be heightened nationally, particularly among women and health professionals."
All the women were participants in the Study of Women's Health Across the Nation (Swan) study based in seven US cities launched in 1996.
When they reached the menopause, the women were questioned about their experiences of childhood and adult abuse, both physical and sexual.
Later they underwent ultrasound tests to detect carotid artery thickening.
"Women who have a history of childhood sexual abuse should report it to their physicians and healthcare providers," Dr Thurston added. "If physicians are able, they should ask about child abuse. Considering child abuse can be important in understanding a woman's cardiovascular risk."
The research is published in the American Heart Association journal Stroke.