Abstract P292: Adverse Childhood Events Are Linked To Cardiovascular and Lung Disease Among Women In Hawaii: The Behavioral Risk Factor Surveillance System Survey, 2010

Abstract

Introduction: Cardiovascular disease ( CVD ), which includes heart disease and stroke, account for about 30% of mortality in Hawaii and affect more women than men. In addition, lung disease ( LD ) (e.g. chronic obstructive pulmonary disease [ COPD ]) continues to rise in the state with a death rate that is also higher among women. Little is known about the association between adverse childhood events ( ACEs ) and CVD or LD among women in Hawaii. Further, although the LD-CVD association has been established, the influence of ACEs in this relationship has yet to be evaluated. HYPOTHESES: We assessed the hypothesis that the type of ACEs (household dysfunction and physical, verbal and sexual abuse) will be positively associated with CVD and LD, and that the LD-CVD association will vary by the presence of ACEs. Methods: Data on 3,477 women residing in Hawaii from the Behavioral Risk Factor Surveillance System Survey was used to examine the relationship between ACEs and CVD (coronary heart disease [ CHD ], myocardial infarction [ MI ], stroke), or LD (COPD, asthma) using multivariable logistic regression, taking into account sampling method. The LD-CVD association was also investigated, with ACE types evaluated as potential modifiers. CVD and LD were assessed as individual ailments (e.g. CHD, COPD) and combined (any CVD, any LD). Covariates included socio-demographics, health behaviors (current smoking status, binge drinking), emotional support, BMI and current depressive symptoms status. Results: Evaluation by ACE type revealed a significant relationship between household dysfunction and CHD (OR=2.6, CI=1.4, 5.0) and any CVD (OR=1.8, CI=1.2, 2.7). Physical abuse was also found associated with COPD (OR=2.1, CI=1.3, 3.6), while verbal abuse was found related with asthma (OR=1.6, CI=1.2, 2.2) and any LD (OR=1.6, CI=1.2, 2.1). Further, physical abuse modified the association between COPD and MI (p=0.003) or any CVD (p=0.042), with a positive association found in the absence but not the presence of physical abuse (OR=3.9 vs. 0.1 and 2.9 vs. 0.7, respectively). The same trend was found for sexual abuse in the asthma-MI relationship (OR=2.6 vs. 0.5). Noteworthy was that individuals who did not report childhood physical or sexual abuse were more likely to have diabetes than those reporting abuse (p<0.05 for both ACE). Conclusions: In conclusion, it might be of benefit to investigate the presence of ACEs, particularly household dysfunction and physical and verbal abuse, in treating CVD or LD among women in Hawaii. Decreasing the prevalence of ACEs might also lower CVD or LD morbidity and mortality in this population. Although the COPD-MI, or any CVD, and asthma-MI associations were significantly positive only among those who reported physical or sexual abuse, respectively, this cohort had a greater prevalence of diabetes, which might influence these relationships. These findings warrant further investigation.