Childhood adversity and mechanistic links to hypertension risk in adulthood

Abstract

Adverse childhood experiences (ACEs), defined as traumatic events in childhood that range from various forms of abuse to household challenges and dysfunction, have devastating consequences on adult health. Epidemiological studies in humans and animal models of early life stress (ELS) have revealed a strong association and insight into the mechanistic link between ACEs and increased risk of cardiovascular disease (CVD). This review focuses on the mechanistic links of ACEs in humans and ELS in mice and rats to vasoactive factors and immune mediators associated with CVD and hypertension risk, as well as sex differences in these phenomena. Major topics of discussion in this review are as follows: (a) epidemiological associations between ACEs and CVD risk focusing on hypertension, (b) evidence for association of ACE exposures to immune-mediated and/or vasoactive pathways, (c) rodent models of ELS-induced hypertension risk, (d) proinflammatory mediators and vasoactive factors as mechanisms of ELS-induced hypertension risk. We also provide some overall conclusions and directions of further research. LINKED ARTICLES: This article is part of a themed section on Immune Targets inHypertension. To view the other articles in this section visit BJP CVD risks. Anda and colleagues at the CDC reported highly significant associations with ACEs and ischaemic heart disease (IHD) and unexpectedly found that these psychological factors were statistically more relevant than the traditional risk factors for IHD (Dong et al., 2004).Apart from parental marital discord, the prevalence of IHD increased significantly among individuals who experienced any of the individual ACEs. In addition, individuals who experienced more than seven ACEs were three times more likely to report IHD (Dong et al., 2004). A cross-sectional study utilizing data from the 2002 China National Nutrition and Health Survey of 7,874 adults born between 1954 and 1964 aimed to assess whether exposure to famine in utero, early childhood, mid-childhood, and/or late childhood is associated with increased risk of metabolic syndrome in adult life. The authors defined metabolic syndrome as an individual having three or more of the following parameters measured: (a) fasting triglyceride >150 mg·dL −1 , (b) HDL cholesterol <40 mg·dL −1 in men or <50 mg·dL −1 in women, (c) fasting glucose >100 mg·dL −1 , (d) waist circumference >102 cm in men or >88 cm in women, and (e) systolic and diastolic BP ≥130and 85 mmHg respectively. The results showed that adults who were exposed to severely affected famine areas and less severely affected famine areas during early childhood had significantly increased prevalence of metabolic syndrome than individuals who were not exposed to famine. No differences were observed if exposure to famine occurred during mid or late childhood (Y. Li et al., 2011). The national survey study in England utilized the same ACE questionnaire from the CDC ACE cohort study to examine the association between CVD (defined in this study as coronary heart disease and heart...

Socio-Cultural Constraints in Protecting Child Rights in a Society in Transition: A Review and Synthesis from Oman

“…Abdominal/thoracic injuries (Kotch et al 1993) Acquire brain injuries (Buchweitz et al 2019) Bruises, welts, lacerations, and abrasions (Alexander et al 2001) Fractures (Felitti 1998) Eyes injuries (McBeth et al 1999) Sexual and reproductive ill-health Reproductive health problems (Cooperman and Merten 2001) Sexual dysfunction (Rapsey et al 2019) Sexually transmitted diseases, including HIV/AIDS (Shamu et al 2019) Unwanted pregnancy (Hall et al 2019) Cognitive, emotional and behavioral disorders Developmental delays (Croft et al 2019) Alcohol and drug abuse (Cicchetti and Handley 2019) Cognitive impairment (Aas et al 2019) Delinquent, violent and other risk-taking behaviors (Mumford et al 2019) Depression and anxiety (Rapsey et al 2019) Deliberate food restriction and body-image problem (Bahji et al 2019) Feelings of shame and guilt (Baiden et al 2019) Poor self-esteem (McDonald et al 2019) Post-traumatic stress disorder (Hartley et al 2016) Deliberate self-harm and Suicidal behavior (Shapero et al 2019) Other longer-term health consequences Cancer (Henchoz et al 2019) Respiratory diseases (Riedl et al 2019) Fibromyalgia (Varinen et al 2019) Irritable bowel syndrome (Parker et al 2019) Ischemic heart disease (Obi et al 2019) Reproductive health problems such as infertility (Panisch 2019) Child maltreatment tends to trigger a myriad of physical, sexual and reproductive problems in addition to cognitive, emotional and behavioral disorders as shown in Table 2. It might also be advisable for those working in the caregiving profession to be trained in the biopsychosocial approach.…”

Death of a parent during childhood and blood pressure in youth: a population-based cohort study of Swedish men

“… 14 These in turn may induce stress-related physiological changes related to the dysregulation of the hypothalamic–pituitary–adrenocortical axis and of the sympathetic nervous system; these enhance pro-inflammatory activity and may overactivate the renin–angiotensin–aldosterone system. 15 Chronic stress may also lead to unhealthy lifestyle. 16 Such physiological and behavioural changes may increase blood pressure (BP) and the risk of other cardiovascular diseases (CVD) (eg, ischaemic heart diseases, stroke) or cardiac mortality, 17 18 already in young age.…”

“… 34 35 The prevalence of elevated BP among children and young adults has been increasing. 36 37 Though adverse childhood experiences (most often defined in terms of maltreatment and family dysfunction), are associated with an increased risk of hypertension in middle age and old age, 15 38 39 knowledge about their association with high BP in youth is more limited. 40–43 …”

Examining the Influence of Early Life Stress on Serum Lipid Profiles and Cognitive Functioning in Depressed Patients

“…A vast number of studies report that early life adversity may increase cardiovascular risk factors and the occurrence of CVD (Batten et al, 2004; Dong et al, 2004; Goodwin and Stein, 2004; Danese et al, 2009; Fuller-Thomson et al, 2010, 2012; Korkeila et al, 2010; Stein et al, 2010; Scott et al, 2011; Rich-Edwards et al, 2012; Basu et al, 2017; Murphy et al, 2017; Reid et al, 2018; Doom et al, 2019; Obi et al, 2019). These studies document that childhood adversities are associated with hypertension (Danese et al, 2009; Stein et al, 2010; Reid et al, 2018; Doom et al, 2019), higher BMI (Doom et al, 2019), ischemic heart disease (Dong et al, 2004) and myocardial infarction (Fuller-Thomson et al, 2012).…”