Sex-specific differences in the circulatory response to postural stress among young adults with adverse childhood experiences (ACEs)

Abstract

Adverse childhood experiences (ACEs)—a highly prevalent assortment of traumatic childhood events (e.g., abuse)—are strongly linked to adult cardiovascular disease (CVD), though differently among males and females. Biological sex differences in the circulatory response to physiological stress (e.g., postural stress) have been well-characterized; however, whether ACEs affect this response differently among males and females remains unclear. This study tested the hypothesis that ACEs affect the circulatory response to head-up tilt (HUT; postural stress) differently among males and females. Three hundred ( n = 156 female; 22.4 ± 1.8 years) young adults recruited through the Niagara Longitudinal Heart Study (NLHS) were included in the current analyses. ACEs were assessed (Childhood Trust Events Survey 2.0) and participants were dichotomized into high (≥4 ACEs) and low (<4 ACEs) exposure groups. Beat-by-beat mean arterial pressure (MAP; finger photoplethysmography) and heart rate (HR; electrocardiogram) were recorded during 10-minutes of supine rest and 5-minutes of 60° HUT. Sex-stratified, mixed-model regression analyses assessed the effect of ACEs on changes (Δ) in MAP and HR from supine rest to HUT, adjusting for age, body mass index, physical activity, and smoking status. During HUT, MAP increased to a similar extent in males with high and low ACEs exposure (ΔMAP: 11.5 ± 10.8 mmHg vs. 10.1 ± 10.9 mmHg, respectively; p > 0.05). In contrast, MAP increased to a greater extent in females with high ACEs exposure compared to females with low ACEs exposure (ΔMAP: 11.3 ± 10.4 mmHg vs. 5.9 ± 9.8 mmHg, respectively; p = 0.003). HR increased during HUT in males with both high and low ACEs exposure; however, it increased to a lesser extent in males with high ACEs exposure compared to males with low ACEs exposure (ΔHR: 14.7 ± 7.5 bpm vs. 18.7 ± 8.1 bpm, respectively; p = 0.015). In females, HR increased to a similar extent during HUT in those with high and low ACEs exposure (ΔHR: 16.5 ± 8.1 bpm vs. 17.6 ± 8.9 bpm, respectively; p > 0.05). These data suggest that ACEs affect the circulatory response to postural stress differently in males and females. Further, these data imply that sex-specific differences in circulatory regulation can be observed as early as young adulthood in those reporting high ACEs exposure. This work was supported by the Canadian Institute of Health Research (CIHR) and Brock University This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.