Adverse childhood experiences and myocardial infarction: Analysis of United States Behavioral Risk Factor Surveillance System (BRFSS) data

Abstract

Adverse childhood experiences (ACEs) have been linked to an increased risk of disease in adulthood and a range of other negative health outcomes, including cardiovascular disease (CVD). This study aims to build on previous research on ACEs and CVD by investigating the association between ACEs and heart attack or myocardial infarction diagnosis. Our analysis used cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) annual survey and ACE Module questionnaires. Responses included data from a national sample of 52,492 adults aged 18 years or older in the United States. ACEs value is a composite score of physical, emotional and sexual abuse, household dysfunction, neglect, and other childhood traumas. The study population had a mean number of 1.75 ACEs (SD 2.25), with 61% experiencing at least one ACE and 17% experiencing four or more ACEs. Almost 6% of adults in the sample reported a previous myocardial infarction (5.7%). Multiple logistic regression analysis demonstrated that, after adjusting for a variety of sociodemographic and health covariates, every one-event increase in the number of ACEs was significantly associated with 6% increased odds of myocardial infarction in adulthood (adjusted odds ratio [aOR] = 1.06, 95% confidence interval [CI] = 1.04 – 1.09, p <0.001). Efforts to decrease the incidence of myocardial infarction and reduce cardiac-related mortality in the U.S. should include policies that reduce the occurrence of ACEs and provide resources for adults to address their childhood traumas.