Adverse Childhood Experiences and Blood Pressure in Women in the United States: A Systematic Review

Scott, Jewel; McMillian-Bohler, Jacquelyn; Johnson, Ragan; Simmons, Leigh Ann

doi:10.1111/jmwh.13213

Cited by 13 publications

(7 citation statements)

References 58 publications

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“…As most research on trauma and CVH in Latinas has focused on childhood abuse, our findings contribute to a limited body of literature on the associations of exposure to trauma across the life course with CVH in this population. Moreover, investigators have previously found that lifetime trauma is associated with worse CVH in women (Mason et al, 2012(Mason et al, , 2013Rich-Edwards et al, 2012;Riley et al, 2010;Scott et al, 2021). However, few studies have investigated these associations in Latinas.…”

Section: Discussionmentioning

confidence: 99%

“…However, few studies have examined lifetime trauma in relation to a comprehensive measure of CVH such as LS7. Furthermore, potentially traumatic experiences have been associated with poor CVH in women, but most research has had limited inclusion of racial and ethnic minority adults (Scott et al, 2021; Suglia et al, 2015, 2018). For instance, analyses of data from the Nurses’ Health Study II have found women who report childhood abuse or intimate partner violence are at higher risk of incident hypertension and diabetes (Mason et al, 2013; Riley et al, 2010).…”

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confidence: 99%

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Lifetime Trauma and Cardiovascular Health in Latinas

et al. 2021

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Background: Potentially traumatic experiences throughout the life course are associated with poor cardiovascular health among women. However, research on the associations of trauma with cardiovascular health among Latino populations is limited. Understanding the impact of trauma on cardiovascular health within marginalized populations may provide guidance on developing interventions with a particular focus on preventative care.Objective: The purpose of this descriptive cross-sectional study was to examine the associations of lifetime trauma with cardiovascular health among middle-aged and older Latina women.Methods: Participants were recruited from an existing study in New York City. All participants completed a structured questionnaire to assess lifetime trauma, demographic characteristics (such as age and education), financial resource strain, and emotional support. The Trauma History Questionnaire was used to assess lifetime exposure to potentially traumatic experiences (range 0-24). Cardiovascular health was measured with a validated measure of cardiovascular health from the American Heart Association (Life's Simple 7). We used self-reported and objective data to calculate cardiovascular health scores (range 0-14). Multiple linear regression was used to examine the associations of lifetime trauma with cardiovascular health, adjusted for age, education, financial resource strain, and emotional support. Results:The sample included 50 Latina women with a mean age of 63.1 years, 88% were Dominican, and only 6% had completed a college degree. Women reported an average of 4.8 traumatic experiences. Mean cardiovascular health score was 6.5 (SD = 1.6, range 3-10). Linear regression models found that, after adjusting for age, education, financial resource strain, and emotional support, a higher count of lifetime trauma was associated with worse cardiovascular health. However, this association did not reach statistical significance. Discussion: Women with a higher count of lifetime trauma had worse cardiovascular health scores; this association was not statistically significant. Future studies should investigate associations of lifetime trauma and cardiovascular health in larger and more diverse samples of Latinas. Nurses and other clinicians should incorporate trauma-informed approaches to cardiovascular disease risk reduction to improve the cardiovascular health of Latina women who are survivors of trauma.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Lifetime Trauma and Cardiovascular Health in Latinas

et al. 2021

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“…Fourth, as noted earlier, other exposures to traumatic stress (e.g. sexual abuse during childhood [37,52]) are associated with an increased cardiovascular risk, but we lacked data concerning those early exposures. Differentiating between cardiovascular risk that is associated with particular traumas, and sexspecific associations, is a focal area for future inquiry.…”

Section: Limitationsmentioning

confidence: 97%

Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women

Gaffey

Rosman

Sico

et al. 2022

Journal of Hypertension

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Objectives: Veterans, especially women, are three times more to experience sexual harassment and assault [military sexual trauma (MST)] than civilians. As trauma is associated with elevated cardiovascular risk, we investigated whether MST independently contributes to risk for incident hypertension and whether the effects are distinct among women. Methods:We assessed 788 161 post-9/11 Veterans (Mage ¼ 32.14 years, 13% women) who were free of hypertension at baseline, using nationwide Veterans Health Administration data collected 2001-2017. Time-varying, multivariate Cox proportional hazard models were used to examine the independent contribution of MST to new cases of hypertension while sequentially adjusting for demographics, lifestyle and cardiovascular risk factors, including baseline blood pressure, and psychiatric disorders including posttraumatic stress disorder. We then tested for effect modification by sex.Results: Over 16 years [mean ¼ 10.23 (SD: 3.69)], 35 284 Veterans screened positive for MST (67% were women). In the fully adjusted model, MST was associated with a 15% greater risk of hypertension [95% confidence interval (95% CI) 1.11-1.19]. In sex-specific analyses, men and women with a history of MST showed a 6% (95% CI, 1.00-1.12, P ¼ 0.042) and 20% greater risk of hypertension (95% CI, 1.15-1.26, P < 0.001), respectively. Conclusion:In this large prospective cohort of young and middle-aged Veterans, MST was associated with incident hypertension after controlling for established risk factors, including trauma-related psychiatric disorders. Although MST is disproportionately experienced by women, and the negative cardiovascular impact of MST is demonstrated for both sexes, the association with hypertension may be greater for women. Subsequent research should determine if early MST assessment and treatment attenuates this risk.

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“…6,7 There is growing evidence that childhood trauma is associated with increased risk for hypertension in adulthood. [8][9][10] For instance, a 2017 systematic review of 24 studies found that childhood trauma was positively associated with hypertension in 60% of included studies. 9 Furthermore, analyses of data from the Nurses' Health Study found that sexual and physical abuse prior to age 18 had a dose-dependent relationship with hypertension.…”

Section: Introductionmentioning

confidence: 99%

The Interaction of Trauma Exposure and DNA Methylation on Blood Pressure Among Black Women in the InterGEN Study

et al. 2022

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Objective: Despite evidence that trauma exposure is linked to higher risk of hypertension, epigenetic mechanisms (such as DNA methylation) by which trauma potentially influences hypertension risk among Black adults remain understudied. Methods: Data from a longitudinal study of Black mothers were used to test the hypothesis that direct childhood trauma (ie, personal exposure) and vicarious trauma (ie, childhood trauma experienced by their children) would interact with DNA methylation to increase blood pressure (BP). Separate linear mixed effects models were fitted at each CpG site with the DNA methylation beta-value and direct and vicarious trauma as predictors and systolic and diastolic BP modeled as dependent variables adjusted for age, cigarette smoking, and body mass index. Interaction terms between DNA methylation beta-values with direct and vicarious trauma were added. Results: The sample included 244 Black mothers with a mean age of 31.2 years (SD = ±5.8). Approximately 45% of participants reported at least one form of direct childhood trauma and 49% reported at least one form of vicarious trauma. Epigenome-wide interaction analyses found that no CpG sites passed the epigenome-wide significance level indicating the interaction between direct or vicarious trauma with DNAm did not influence systolic or diastolic BP. Conclusions: This is one of the first studies to simultaneously examine whether direct or vicarious exposure to trauma interact with DNAm to influence BP. Although findings were null, this study highlights directions for future research that investigates epigenetic mechanisms that may link trauma exposure with hypertension risk in Black women.

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Adverse Childhood Experiences and Blood Pressure in Women in the United States: A Systematic Review

Cited by 13 publications

References 58 publications

Lifetime Trauma and Cardiovascular Health in Latinas

Lifetime Trauma and Cardiovascular Health in Latinas

Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women

The Interaction of Trauma Exposure and DNA Methylation on Blood Pressure Among Black Women in the InterGEN Study

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