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...