Sexual assault and harassment may take a long-term toll on women’s health.

A new JAMA Internal Medicine study, adding to a growing body of literature on the issue, linked a history of workplace sexual harassment with higher blood pressure and poorer sleep. It also found an association between history of sexual assault and depression, anxiety and poorer sleep.

The study authors asked 304 women aged 40 to 60 — 19% of whom said they had a history of workplace sexual harassment, 22% of whom said they had a history of sexual assault, and 10% of whom reported experiencing both — to undergo health assessments and answer questionnaires.

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Women with history of sexual harassment had significantly higher blood pressure and significantly poorer sleep quality than those who had no such history, the authors found. (Elevated blood pressure, they noted, is a key risk for cardiovascular disease, the leading cause of death among U.S. women.) And sexual assault was linked with significantly higher odds of elevated depressive symptoms, anxiety and poor sleep quality.

A 2014 Centers for Disease Control report estimated that 19.3% of women had been raped during their lifetimes, and 43.9% had experienced other forms of sexual violence. And 81% percent of women say they’ve experienced some form of sexual harassment and/or assault during their lifetimes, according to a nationally representative survey from the nonprofit Stop Street Harassment published in February.

“Future work should consider whether preventing or mitigating sexual harassment and sexual assault can improve women’s mental and cardiovascular health,” study authors Rebecca Thurston, Yuefang Chang and Karen Matthews concluded. “Given the high prevalence of sexual harassment and assault, addressing these prevalent and potent social exposures may be critical to promoting health and preventing disease in women.”

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Previous studies have linked sexual harassment to depression, anxiety and low self-esteem; they have also related them to “increased odds of illness, injury, or assault,” as well as obesity, pain disorders and worse sleep. Thurston, a University of Pittsburgh epidemiologist, found in previous research that mid-life women with three or more lifetime exposures to a slate of traumatic events — among them unwanted sexual contact and physical or verbal workplace sexual harassment — had worse blood-vessel function than those who were less exposed to trauma.

Thurston stressed the importance of examining “not only what’s going on in people’s heads, but what’s going on in their social environments that may put them at risk” during a February interview with Moneyish. “I just think practitioners need to think about intervening with both the mind and the body,” she said. “Addressing both of those pathways is going to be crucial.”