Sex differences in the association between childhood maltreatment and cardiovascular disease in the UK Biobank

Abstract

ObjectivesTo assess and compare associations between childhood maltreatment and cardiovascular disease (CVD) in men and women in the UK. In secondary analyses, we also explored possible age differences and associations with early onset CVD (<50 years).MethodsWe included 157 311 participants from the UK Biobank who had information on physical, sexual or emotional abuse, emotional or physical neglect. CVD outcomes were defined as any CVD, hypertensive disease, ischaemic heart disease (IHD) and cerebrovascular disease. These were extracted from self-report, blood pressure measurements, hospital register and death register. The associations between maltreatment and CVD were assessed using Poisson regression with robust variance to estimate risk ratios, stratified by sex and adjusted for socioeconomic and demographic factors.ResultsAll types of maltreatment were associated with increased risk of CVD and IHD in both sexes. Additionally, in women all types of maltreatment were associated with higher risk of hypertensive disease, and all, except emotional neglect, were associated with cerebrovascular disease. In men, all but sexual abuse, were associated with higher risk of hypertensive disease, and all, except physical and sexual abuse, were associated with cerebrovascular disease. Associations were generally stronger in women, and individuals who were younger at baseline had stronger associations of childhood maltreatment with any CVD and IHD, but age differences were less evident when only early onset CVD was considered.ConclusionsChildhood maltreatment was consistently associated with CVD and stronger associations were generally observed in women and seemed to be stronger for early onset CVD.

The invisible scars of emotional abuse: a common and highly harmful form of childhood maltreatment

“…It is also important to keep in mind that the co-occurrence of different types of childhood maltreatment might have influenced our results. Furthermore, the sample was predominantly female, which might have inflated our results, as recent studies have shown that the prevalence of emotional abuse is higher for women than for men [ 34 , 80 , 81 ]. All sources of data were obtained using the same method, self-report questionnaires, which could lead to common method variance.…”

Child maltreatment and neglect in the United Arab Emirates and relationship with low self-esteem and symptoms of depression

“…In economically developed countries, where infectious disease related deaths have declined due to early diagnosis, use of antibiotics and vaccinations, child maltreatment is a substantial contributor to child mortality (Hillis et al, 2016). This observation stems from population-based studies which have reported an association between child maltreatment and an increased risk of long-term mental disorders and physical conditions such as cardiovascular disease contributing to premature death (Chandan et al, 2019;Edwards et al, 2003;Gilbert et al, 2009;Soares et al, 2020).…”

Does the association of child maltreatment with adult cardiovascular disease differ by gender?

“…The associations were generally stronger in women than men, although the gender differences were mostly modest. In particular, the associations of physical abuse with ischaemic heart disease (relative risk 1.47 for women vs 1.19 for men) and with any CVD (1.14 vs 1.07), and emotional neglect with ischaemic heart disease (1.41 vs 1.18) were significantly stronger in women (2).…”