Adverse childhood experiences and the cardiovascular health of children: a cross-sectional study

Abstract

BackgroundAdverse childhood experiences (ACEs), such as abuse, household dysfunction, and neglect, have been shown to increase adults’ risk of developing chronic conditions and risk factors for chronic conditions, including cardiovascular disease (CVD). Much less work has investigated the effect of ACEs on children’s physical health status that may lead to adult chronic health conditions. Therefore, the present study examined the relationship between ACEs and early childhood risk factors for adult cardiovascular disease.Methods1 234 grade six to eight students participated in school-based data collection, which included resting measures of blood pressure (BP), heart rate (HR), body mass index (BMI) and waist circumference (WC). Parents of these children completed an inventory of ACEs taken from the Childhood Trust Events Survey. Linear regression models were used to assess the relationship between experiencing more than 4 ACEs experienced, systolic BP, HR, BMI and WC. In additional analysis, ACEs were assessed ordinally in their relationship with systolic BP, HR, and BMI as well as clinical obesity and hypertension status.ResultsAfter adjustment for family education, income, age, sex, physical activity, and parental history of hypertension, and WC for HR models, four or more ACEs had a significant effect on HR (b = 1.8 bpm, 95% CI (0.1-3.6)) BMI (b =1.1 kg/m2, 95% CI (0.5-1.8)), and WC (b = 3.6 cm, 95% CI (1.8-5.3)). A dose–response relationship between ACE accumulation and both BMI and WC was also found to be significant. Furthermore, accumulation of 4 or more ACEs was significantly associated with clinical obesity (95th percentile), after controlling for the aforementioned covariates.ConclusionsIn a community sample of grade six to eight children, accumulation of 4 or more ACEs significantly increased BMI, WC and resting HR. Therefore, risk factors related to reported associations between ACEs and cardiovascular outcomes among adults are identifiable in childhood suggesting earlier interventions to reduce CVD risk are required.

Adverse Childhood Experiences and Health in Adulthood in a Rural Population-Based Sample

“…18 Consistent with previous studies, 13,14,28,30,31 ACEs were associated with several negative health and social outcomes, including unemployment, use of public assistance for medical care, lack of emotional support, dissatisfaction with life, poor general and physical health, occurrence of frequent mental distress, limitations cause by mental or physical health issues, smoking, heavy drinking, increased body mass index, and diagnoses of depression, anxiety, and asthma. However, some interesting inverse associations between ACEs and specific medical diagnoses were also noted and have not been reported previously.…”

“…13,18,28 These and other studies of childhood adversity from the US and around the world using a variety of data sources clearly demonstrate that ACEs are linked to poorer social, economic, behavioral, and physical health outcomes in adulthood. [6][7][8][9][10][11][12][14][15][16] In this first community-based study to link self-reported ACEs to comprehensive health measures documented in the medical record, we also demonstrated a link between childhood adversity and poor outcomes in adulthood, but found that for a number of specific medical diagnoses, findings were inconsistent with previous reports.…”

“…Although BRFSS data and other large cross-sectional surveys allow for population-based assessment, the health outcome measures examined in these cases are self-reported. 7,[10][11][12][13][14][15][16]18 Conversely, longitudinal follow-up and access to validated medical diagnoses in several other published studies is limited to populations with access to healthcare either via enrollment in a specific insurance plan or through nationalized healthcare programs. 8,9,[19][20][21][22][23][24][25] Survey respondents in the present study were not limited to those covered by a specific healthcare plan, but did have data captured over time in the EMR of regional healthcare provider Marshfield Clinic, providing a unique perspective amongst published ACE studies.…”

“…13,18 The majority of studies published regarding the association between ACEs and adverse health outcomes in adults, including those based on the BRFSS questionnaire, relied largely on self-report or cross-sectional analysis of data captured at a single time point. 7,[10][11][12][14][15][16] However, longitudinal follow-up of the original ACE study performed by Felitti et al 3 has allowed for abstraction of additional, validated data related to prescriptions, diseases (e.g., chronic obstructive pulmonary disease, autoimmune disease, lung cancer), and mortality in a subset of more than 15,000 patients. [19][20][21][22][23] Similarly, population-based Swedish cohort studies have longitudinally linked measurable indicators of childhood household dysfunction with poor mental health outcomes and psychotropic medication use 8,9 and the long-term British National Child Development Study found a link between ACEs and cancer risk in adulthood as well as premature all-cause mortality.…”

(Trans‑)Generationale Weitergabe früher Traumatisierung auf das kardiovaskuläre System

“…Auch für die kardiovaskuläre Regulation (Sartori et al 2016), aber ebenso für kardiovaskuläre Risikofaktoren wie das metabolische Syndrom konnten systematische Veränderungen epigenetischer Markierungen nachgewiesen werden (Park et al 2017 (Spitzer et al 2016;Su et al 2015). Dieser dosisabhängige Zusammenhang zwischen ACE und dem kardiovaskulären Gesundheitsstatus konnte ebenso bereits für Kinder und Jugendliche im Alter zwischen 11 und 14 Jahren nachgewiesen werden (Pretty et al 2013 …”