Association of Exposure to Abuse, Nurture, and Household Organization in Childhood With 4 Cardiovascular Disease Risks Factors Among Participants in the CARDIA Study

Abstract

Background We investigated associations of childhood abuse with 4 cardiovascular disease risk factors in adulthood, and whether exposure to nurturing and household organization in childhood mitigated these associations. Methods and Results The CARDIA (Coronary Artery Risk Development in Young Adults) study (baseline examination, 1985–1986) was used to examine associations of childhood exposures (measured retrospectively at the year 15 examination) with incident obesity, type 2 diabetes, hypertension, and hyperlipidemia (assessed from baseline to year 30). Race‐ and sex‐stratified Cox proportional hazards models were used to examine associations of exposure to childhood abuse with incident cardiovascular disease risk factors. Interaction terms between exposure to abuse and exposure to nurturing relationship and household organization were included to test for effect modifications. Exposure to occasional/frequent abuse (versus no abuse) was associated with incident type 2 diabetes among White men (hazard ratio [HR], 1.81; 95% CI, 1.06–3.08). Exposure to low versus no abuse was associated with incident hyperlipidemia among White men (HR, 1.35; 95% CI, 1.09–1.67) and White women (HR, 1.26; 95% CI, 1.01–1.56). Risks of incident hyperlipidemia were higher for White women who experienced abuse and lived in dysfunctional households (HR, 3.61; 95% CI, 1.62–8.05) or households with low levels of organization (HR, 2.05; 95% CI, 1.25–3.36) compared with White women who experienced abuse but lived in well‐organized households (HR, 0.66; 95% CI, 0.41–1.06). Similar patterns were seen for Black men who lived in dysfunctional households (HR, 3.62; 95% CI, 1.29–10.12) or households with low organization (HR, 2.01; 95% CI, 1.08–3.72). Conclusions We identified race‐ and sex‐specific associations of childhood exposures with incident cardiovascular disease risk factors. The associations of household organization and dysfunction with cardiovascular disease risks merits further investigation.

Time-lagged associations between two adverse childhood experiences and later-life cognitive function through educational attainment and stroke

“…One study with prospectively collected data from children with objectively determined (i.e., via court records) physical abuse and non-abused, case-matched counterparts showed that abused children had more risk factors for cardiovascular and cerebrovascular diseases in midlife (Widom et al, 2012). Similar findings have been shown in middle-aged adults who retrospectively reported childhood physical abuse (Aguayo et al, 2022; Carroll et al, 2013).…”

“…Stroke may also link childhood adversity to poorer later-life cognitive function independent of educational attainment. Previous studies have linked childhood abuse and parental substance abuse to perturbed inflammatory responses (Carroll et al, 2013) and poor physical health outcomes (Aguayo et al, 2022). Chronic exposure to ACEs can become biologically embedded and lead to prolonged dysregulation in hormonal, inflammatory, and cardiovascular functions that impact health throughout the life course (Felitti, 2009; Miller et al, 2011; Su et al, 2015; Wade et al, 2019).…”

American Heart Association's Children's Strategically Focused Research Network Experience

“…Nearly a century after AHA began and half a century after commissioning of Cardiovascular Disease in the Young, the Children's Strategically Focused Research Network (SFRN) was established to apply state‐of‐the‐art basic, clinical, and population science strategies and train the next generation of pediatric cardiology scientists while still embodying Cardiovascular Disease in the Young's original focus on RHD, CHD, and preventive cardiology. The Children's SFRN directly and proudly builds on work done by the early pioneers in of pediatric cardiovascular science within AHA in the 1940s and 1950s.This article highlights the hypotheses, goals, accomplishments, challenges, and future directions of each center; provides an overview of collaboration efforts (Table 1 ) 1 , 2 , 3 , 4 and trainee accomplishments (Table 2 ) 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ; and summarizes how we can leverage the output of this SFRN to advance pediatric cardiovascular science.…”

Evidence for the Association Between Adverse Childhood Family Environment, Child Abuse, and Caregiver Warmth and Cardiovascular Health Across the Lifespan: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

“…For example, prior studies show that adverse childhood environments are correlated with subclinical atherosclerosis, incident type 2 diabetes, hypertension, hyperlipidemia, and CVD and mortality in CARDIA and other cohorts. [20][21][22][23] Our study is among the first to modify the conceptual models of these collective studies to instead consider an outcome variable beyond metrics of disease or individual risk factors, and instead of a modifiable risk factor composite measure. This study further considers the protective exposure of caregiver warmth, beyond solely a risk exposure (adversity).…”