Investigating the associations between childhood trauma and cardiovascular health in midlife

Abstract

Growing evidence suggests that childhood trauma is associated with poorer cardiovascular health in adulthood, but few studies have examined potential mediators of these associations. We examined the links between different forms of childhood trauma (i.e., abuse, neglect, cumulative trauma) and cardiovascular health and explored potential mediators. Cross‐sectional data from 1,251 participants in the National Survey of Midlife Development in the United States’ II Biomarker Project were analyzed. Path analyses were conducted to examine the associations between childhood trauma and cardiovascular health (i.e., American Heart Association's Life's Simple 7 [LS7] score). Depressive symptoms and sleep quality were explored as potential mediators, and exploratory analyses examined whether these associations were moderated by sex. Women reported more severe childhood emotional and sexual abuse and emotional neglect, p < .001 to p = .018, and higher LS7 scores, p = .027, than men. Path analyses demonstrated the total effects of increasing severity of all forms of childhood trauma with LS7 scores were significant, and cumulative childhood trauma was inversely associated with LS7 score Bs = ‐0.306– ‐0.076, p < .001–p = .048. The range of total effects of different forms of childhood trauma on LS7 scores mediated by depressive symptoms and sleep quality was 26.8%–57.5%. Sex moderated the associations between all forms of childhood trauma and cardiovascular health. Longitudinal studies are needed that examine mediators of the associations between childhood trauma and cardiovascular health. Findings suggest sex‐specific, trauma‐informed approaches for cardiovascular disease prevention in adults exposed to childhood trauma may be needed.

Lifetime Trauma and Cardiovascular Health in Latinas

“…To our knowledge, only one prior study has examined the influence of any form of trauma on LS7 scores in any population. Using data from the Midlife in the United States (MIDUS) Study, investigators found that a greater severity of childhood trauma (i.e., abuse and neglect) was associated with worse CVH (measured using LS7) in a multiethnic sample of middle-aged and older adults (Caceres et al, in press). Our findings are consistent with the findings of that study (Caceres et al, in press), but instead of only examining childhood trauma, we assessed trauma exposure across the life span.…”

“…Using data from the Midlife in the United States (MIDUS) Study, investigators found that a greater severity of childhood trauma (i.e., abuse and neglect) was associated with worse CVH (measured using LS7) in a multiethnic sample of middle-aged and older adults (Caceres et al, in press). Our findings are consistent with the findings of that study (Caceres et al, in press), but instead of only examining childhood trauma, we assessed trauma exposure across the life span. As most research on trauma and CVH in Latinas has focused on childhood abuse, our findings contribute to a limited body of literature on the associations of exposure to trauma across the life course with CVH in this population.…”

Considering Social Context to Understand Childhood Adversities and Cardiovascular Health

“…The present study found that for every 1-unit increase in Risky Family score, the odds of attaining high CVH (≥10) decreased by 3.6% (odds ratio, 0.9645 [95% CI, 0.94-0.98]). This study adds to a series of work 7,8 identifying the role of childhood adversity in influencing modifiable risk factors for cardiovascular disease. It expands the conceptualization of adversity by considering the frequency of experiences, which has not always been considered in prior work.…”

“…9 For example, work with the National Survey of Midlife Development in the United States has shown depressive symptoms to mediate associations between childhood trauma and cardiovascular health. 7 Behavioral factors such as sleep quality and quantity have also been associated with childhood adversity, as well as mediated the association between adversities and cardiovascular health. 7 In fact, sleep is now the eighth component of American Heart Association’s cardiovascular health metric, given its importance in the development of cardiovascular disease.…”

“…7 Behavioral factors such as sleep quality and quantity have also been associated with childhood adversity, as well as mediated the association between adversities and cardiovascular health. 7 In fact, sleep is now the eighth component of American Heart Association’s cardiovascular health metric, given its importance in the development of cardiovascular disease. 10 Physiologically, experiences of trauma in early life have been shown to promote a proinflammatory state, as well as dysregulate the hypothalamic-pituitary-adrenal-axis and the sympathetic and adrenomedullary system, which may influence the development of cardiometabolic risk factors.…”