A new study has found that risk factors for heart disease and stroke were higher among adults who said they had been abused as children and varied by race and gender. However, those who described their family life as well managed and whose family members were involved in their lives during childhood were less likely to have increased cardiovascular risk factors in adulthood, according to a new study. research published today in the Journal of the American Heart Associationan open access peer-reviewed journal of the American Heart Association.
Although cardiovascular disease, which includes heart disease and stroke, is more common in older people, the risks often begin much earlier in life. Previous research confirms that physical and psychological abuse and other negative experiences in childhood increase the risk of developing obesity, type 2 diabetes, high blood pressure and high cholesterol, which, in turn, increase the risk of cardiovascular disease, as detailed in the 2018 American Heart Association Scientific Statement: Childhood and Adolescence Adversity and Cardiometabolic Outcomes.
Conversely, healthy childhood experiences – nurturing and loving relationships in a well-run household, including family members involved and engaged in the child’s life – can increase the likelihood of healthy behaviors for the child. heart that can reduce the risk of cardiovascular disease. In this study, researchers explored whether nurturing relationships and well-managed households could offset the likelihood of higher cardiovascular risk factors.
“Our results demonstrate how the negative and positive experiences we have in childhood can have long-term cardiovascular consequences in adulthood and define major disparities in heart disease risk by race and sex,” said the study’s lead author, Liliana Aguayo, Ph.D., MPH, a social epidemiologist and assistant research professor at Emory University’s Rollins School of Public Health in Atlanta.
Researchers reviewed information from the Coronary Artery Risk Development in Young Adults (CARDIA) study, an ongoing, long-term study of 5,115 black and white adults enrolled from 1985-1986 to 2015-2016. Study enrollment took place in four US cities: Birmingham, Alabama; Chicago; Minneapolis; and Oakland, California. More than half of the study participants were women and almost half were black adults. At the start of the study, the participants were on average 25 years old. All participants received initial clinical exams and eight additional exams every few years to assess cardiovascular risk over 30 years.
Between the ages of 33 and 45, participants answered a survey of questions to assess areas of their family life during childhood. For this analysis, three areas were examined:
- Abuse: how many times has a parent or adult in their home pushed, grabbed, shoved or hit them so hard that they were hurt; and how often a parent or adult in their household swore at, insulted or threatened them.
- Nurture: How often did a parent or adult make them feel loved, supported or cared for? and the frequency with which a parent or adult in the family expressed gestures of warmth and affection.
- Household organization: Did they feel the household was well run, and did their family know where they were and what they were doing most of the time. (No definition or criteria were provided for the term “well-managed”; study participants were tasked with determining whether the term described their childhood family experience.)
Participants were ranked based on their answers to the survey questions:
- About 30% of participants reported experiencing “occasional/frequent abuse”, which included those who answered “occasionally or for a moderate amount of time” or “most of the time or all the time” to the abuse-related questions .
- About 20% of participants reported experiencing violence “sometimes or a little,” which was categorized as “low violence.”
- About half of the participants reported no childhood abuse and described their childhood family life as nurturing and well managed.
Among adults who reported childhood abuse, the risk of type 2 diabetes and high cholesterol – but not obesity and high blood pressure – was higher than among adults who did not. no childhood abuse. The increased risk, however, seemed to vary by gender and race.
The researchers noted:
- The risk of high cholesterol was 26% higher in white women and 35% higher in white men who reported low levels of childhood abuse, compared to adults of the same sex and race who did not. reported no childhood abuse.
- The risk of type 2 diabetes was 81% higher in white males who reported occasional/frequent childhood abuse, compared to adults who reported no childhood abuse.
- Black men and white women who reported experiencing abuse and growing up in a dysfunctional home were more than 3.5 times more likely to develop high cholesterol than those who reported no childhood abuse. In contrast, among people who said they grew up in a well-managed household, the risk of high cholesterol decreased by more than 34%.
- An unexpected finding: the risk of cardiovascular disease risk factors was not higher among black women who reported having been victims of violence in childhood.
Several limitations may have affected the results of the study. This study was a retrospective analysis of data collected in the CARDIA study in 2015-2016; no new surveys were conducted among CARDIA study participants. Childhood family experiences questionnaires were completed when participants were adults, relying on memories, which may include inaccuracies or incomplete memories. Additionally, participants’ BMI (body mass index), which is a measure of weight for height, was only recorded in adulthood, with no data on childhood BMI. for comparison purposes.
“Further research is needed to better understand the potential mechanisms linking childhood maltreatment and family environment to higher risk factors for heart disease, as well as the impact of structural racism and social determinants of health, which have probably influenced the differences we found by race and gender,” Aguayo said. “This information is essential for strengthening cardiovascular disease prevention interventions and policies, especially those that focus on people who experienced childhood abuse or other trauma.”
Co-authors are Diana A. Chirinos, Ph.D.; Nia Heard-Garris, MD, M.Sc.; Mandy Wong, MS; Matthew Mason Davis, MD, MAPP; Sharon Stein Merkin, Ph.D., MHS; Teresa Seeman, Ph.D.; and Kiarri N. Kershaw, Ph.D.
The CARDIA study is conducted and supported by the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health, in collaboration with the University of Alabama at Birmingham, Northwestern University, University of Minnesota and the Kaiser Foundation Research Institute. Dr. Aguayo was supported by the American Heart Association while carrying out this project and is currently supported by the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the National Institutes of Health. Dr. Aguayo’s work was also supported in part by a grant from the NIH-funded Emory Specialized Center of Research Excellence in Sex Differences. Dr. Heard-Garris is currently supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health.