The Link Between Childhood Adversity and Cardiovascular Disease Risk: Role of Cerebral and Systemic Vasculature

Abstract

Adverse childhood experiences (ACEs) are traumatic events during the first years of life that are associated with a higher risk of developing cardiovascular disease (CVD) during adulthood. The medial prefrontal cortex (mPFC) is a core region in the brain that modulates emotions and is directly involved in the cardiovascular response to stress by increasing vascular resistance. In the present study we examined the relationship between ACEs, mPFC and peripheral vascular function. Forty-five, adults (33±5 yrs.) participated in the present study to evaluate cerebral hemodynamics and peripheral vascular function. The impact of adverse experiences was evaluated through the ACE questionnaire. Among those that experienced ACEs (ACE group, n = 22), there was a significantly (P<0.001) reduced activation of the mPFC as well as greater peripheral vascular resistance observed in the small (P ≤ 0.035), conduit (P ≤ 0.042) and large (P ≤ 0.001) blood vessels, when compared to those that did not report ACEs (Control group, n = 23). In addition, relationships between the number of ACEs and mPFC activation (rs = -0.428; P = 0.003) and peripheral vascular function (rs≤-0.373; P ≤ 0.009) were observed. Findings from the present study support that adults who experienced ACEs exhibit a reduced activation of the mPFC along with systemic vascular dysfunction. In addition, individuals exposed to more childhood traumatic events exhibited a progressively greater inactivation of the mPFC and an increased peripheral vasoconstriction in a dose-dependent manner. These findings provide novel insights into the potential role that the brain and the peripheral vasculature may have in connecting adverse childhood events to the increased risk of CVD.

How do Adverse Childhood Experiences get Under the Skin to Promote Cardiovascular Disease? A Focus on Vascular Health

“…Specifically, young adult women (∼20 years old) with moderate-to-severe (≥4) ACE exposure exhibited endothelial dysfunction, as measured by the flow mediated-dilation (FMD) technique. Rodriguez-Miguelez and colleagues 3 confirmed the finding of impaired FMD in a cohort of young adult men and women (∼32 years old) and extended these findings by performing comprehensive assessments of medial prefrontal cortex (mPFC) blood flow, microvascular function, and arterial stiffness.…”

“…Despite the pervasiveness of ACEs and robust evidence supporting the association between ACEs and CVD, our current understanding of how ACEs promote CVD is limited. In this issue of Function , Rodriguez-Miguelez and colleagues 3 provide important evidence to further reveal how ACEs ‘get under the skin’ to promote CVD.…”

Exercise to Prevent Accelerated Vascular Aging in People Living With HIV

“…An emerging body of literature suggests that chronic psychosocial stress contributes to premature vascular dysfunction. [265][266][267][268] Alarmingly, the prevalence of posttraumatic stress disorder is particularly high among PLWH, with estimates ranging from 23% to 42%. 269,270 Further, 2 separate cohort studies reported that >50% of PLWH in the United States have a history of childhood physical or sexual abuse.…”