Adverse childhood events have lifelong impact on the heart

Adverse events in childhood have been associated with a variety of lifelong negative health outcomes. A new study in the Journal of the American Heart Association provides more evidence of the impact of such events on adult cardiovascular disease outcomes.¹

Investigators used the CARDIA (Coronary Artery Risk Development in Young Adults) Study, which was a longitudinal cohort that ran from 1985-1986 through 2018. The original cohort was aged 18 to 30 years at the time of enrollment and was recruited from 4 urban areas in the United States: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California.

At the year 15 CARDIA examination, 3646 participants did the Childhood Family Environment (CFE) questionnaire. They were then grouped in high, moderate, or low relative CFE adversity scores. One hundred ninety-eight participants developed cardiovascular disease (CVD) during follow-up.

Among participants with a higher CFE score, there was a trend of higher smoking rates, lower systolic blood pressure, lower socioeconomic status, and higher rates of depressive symptoms. The incidence of CVD was greater than 50% among participants in the high CFE adversity group when compared with those in the low CFE adversity group. The relationship was still significant after adjusting for demographic, socioeconomic, clinical, and psychologic characteristics.

The researchers discussed some limitations to the study. The self-report on the childhood environment could be subject to recall bias. Some participants for the CARDIA study did not complete the year 15 examination. These participants were likely in the higher CFE group due to their lower socioeconomic status, which could mean that the association between adverse childhood events and cardiovascular disease could be underestimated.

As greater than 20% of the sample reported 4 or more out of 7 indicators of adverse childhood environment, the association between childhood trauma and cardiovascular disease is a concerning connection.

References:

1.    Pierce JB, Kershaw KN, Kiefe CI, et al. Association of childhood psychosocial environment with 30-year cardiovascular disease incidence and mortality in middle age. J Am Heart Assoc. 2020;9(9):e015326. doi: 10.1161/JAHA.119.015326