Abstract
Studies assessing associations of childhood psychosocial adversity (e.g. sexual abuse, physical neglect, parental death), as opposed to socioeconomic adversity, with cardiovascular disease (CVD) risk factors in adulthood are scarce. The aim of this study is to assess associations of various types of psychosocial adversity and cumulative adversity in childhood, with multiple CVD risk factors in mid-life. At study enrolment, women from the Avon Longitudinal Study of Parents and Children (N=3612) retrospectively reported: lack of maternal care, maternal overprotection, parental mental illness, household dysfunction, sexual abuse, physical and emotional abuse, and neglect in childhood. Approximately 23 years later, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, plasma glucose, insulin, triglycerides, low and high density lipoprotein cholesterol, C-reactive protein, carotid intima-media thickness (cIMT) and arterial distensibility were assessed (mean age 51 years). We examined associations of each specific type of psychosocial adversity and cumulative adversity with CVD risk factors. No specific type of psychosocial adversity was consistently associated with the CVD risk factors. There was evidence that a one standard deviation greater cumulative psychosocial adversity was associated with 0.51cm greater waist circumference (95% confidence interval [CI]: 0.02cm, 1.00cm, p=0.04) and a lower arterial distensibility, even after adjustment for age, ethnicity and childhood and adult socioeconomic position. We found no consistent evidence that any specific type of psychosocial adversity, or cumulative psychosocial adversity in childhood, is associated with CVD risk factors in adult women.
Highlights
Studying the long-term health consequences of adversity in childhood is important for providing evidence to support the potential benefits of public interventions that seek to prevent adversity in childhood
We found no evidence to suggest that cumulative psychosocial adversity, or any specific type of psychosocial adversity, was consistently associated with cardiovascular disease (CVD) risk factors in adult women, before or after adjusting for childhood socioeconomic position (SEP)
There was evidence to suggest associations of cumulative psychosocial adversity in childhood with only two of the twelve CVD risk factors, and it is possible that psychosocial adversity in childhood is associated with some, but not all CVD risk factors, it is worth noting that there was no evidence of any specific type of psychosocial adversity being associated with either of these two outcomes
Summary
Studying the long-term health consequences of adversity in childhood is important for providing evidence to support the potential benefits of public interventions that seek to prevent adversity in childhood. The American Heart Association recently published a statement to increase awareness of the influence of social factors on the incidence, treatment, and outcomes of CVD. They recommended further observational studies examine the complex interactions between social factors and ardiovascular health (Bayer, Fairchild, Hopper, & Nathanson, 2013). There is consistent evidence showing that socioeconomic adversity in childhood (e.g. low head of household social class, household overcrowding and low parental education) is associated with cardiovascular disease (CVD) risk factors in adulthood (Galobardes, Smith, & Lynch, 2006; Havranek et al, 2015). The Adverse Childhood Experiences (ACE) study has been pivotal in characterising medium and long-term health outcomes of psychosocial adversity in childhood and Felitti et al have previously reported a strong graded relationship between the number of categories of retrospectively reported adverse childhood exposures and the presence of CVD (including ischemic heart disease) in a study of 9508 adults (Felitti et al, 1998)
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