Structured, Progressive Exercise Training Improves Cardiovascular Psychophysiological Outcomes in Young Adult Women with a History of Adverse Childhood Experiences

Abstract

Adverse childhood experiences (ACEs) represent psychosocial stressors that occur during critical developmental periods and are associated in a dose‐dependent manner with adverse cardiovascular outcomes in emerging adults, including greater age‐related increases in blood pressure (BP) and increased circulating endothelin‐1 (ET‐1), a psychosocial stress‐responsive, endothelium‐derived peptide and potent vasoconstrictor. ACEs have also been linked to lower resilience and hope, which is a motivational state based on goal‐directed energy (agency) and goal planning (pathways). Importantly, resilience and hope are each stable psychological traits that may protect against adversity. We examined the effects of a structured, progressive exercise training program on hope agency, hope pathways, resilience, BP, and circulating ET‐1 in young adult women with a history of moderate‐to‐severe (e.g., 4 or more) adverse childhood experiences (ACEs). We hypothesized that exercise training would increase resilience and hope, but lower systolic BP (SBP), diastolic BP (DBP), and circulating ET‐1. We further hypothesized that changes in hope and resilience would be associated with changes in BP and ET‐1 across the intervention period in the young women with ACEs. Forty‐two otherwise healthy young adult women with either four or more (ACE+) or with no ACEs (ACE–) were recruited and completed this study. Participants with ACEs (ACE+) were randomly assigned to either an exercise (n=14) or non‐exercise (n=14) control group, whereas women without a history of ACEs (ACE–) were assigned to a non‐exercise control (e.g., negative control group; n=14). Statistical analyses included two‐way mixed (group x time) effects and bivariate correlational analyses. Changes are reported as means ± SE. Agency did not change in any group (p = 0.14), but pathways improved only in the ACE+ exercise group (+1.6 ± 0.74 au; p = 0.03). ET‐1 decreased in the ACE+ exercise group only (‐0.31 ± 0.29 pg/ml, p= 0.04). While the interactions for resilience and SBP did not reach significance (p = 0.06 and 0.05, respectively), forced post‐hoc analyses indicated that resilience improved (+4.9 ± 1.9 au, p = 0.01) and SBP tended to improve (‐4.0 ± 2.0 mmHg; p = 0.05) in the ACE+ exercise group only. DBP did not change in any group (p = 0.43). There were significant inverse associations between changes in pathways and SBP (ρ = ‐0.43, p= 0.02) and pathways and ET‐1 (ρ = ‐0.56, p= 0.003), and a significant direct association between changes in SBP and ET‐1 (ρ = 0.49; p = 0.01) in the ACE+ young women. Associations among resilience and BP and ET‐1 were weaker and non‐significant (ρ = ‐0.17–0.29, p≥ 0.13). Our results suggest that structured, progressive exercise training promotes improvements in positive psychological factors, SBP, and circulating ET‐1 levels in young adults with a history of ACEs. Further, changes in pathways were related to changes in SBP and ET‐1 across the intervention period, suggesting a potential psychophysiological relationship between positive psychological traits and cardiovascular risk factors in young women with ACEs.