Author:
Pretty Chelsea,O’Leary Deborah D,Cairney John,Wade Terrance J
Abstract
Abstract
Background
Adverse childhood experiences (ACEs), such as abuse, household dysfunction, and neglect, have been shown to increase adults’ risk of developing chronic conditions and risk factors for chronic conditions, including cardiovascular disease (CVD). Much less work has investigated the effect of ACEs on children’s physical health status that may lead to adult chronic health conditions. Therefore, the present study examined the relationship between ACEs and early childhood risk factors for adult cardiovascular disease.
Methods
1 234 grade six to eight students participated in school-based data collection, which included resting measures of blood pressure (BP), heart rate (HR), body mass index (BMI) and waist circumference (WC). Parents of these children completed an inventory of ACEs taken from the Childhood Trust Events Survey. Linear regression models were used to assess the relationship between experiencing more than 4 ACEs experienced, systolic BP, HR, BMI and WC. In additional analysis, ACEs were assessed ordinally in their relationship with systolic BP, HR, and BMI as well as clinical obesity and hypertension status.
Results
After adjustment for family education, income, age, sex, physical activity, and parental history of hypertension, and WC for HR models, four or more ACEs had a significant effect on HR (b = 1.8 bpm, 95% CI (0.1-3.6)) BMI (b =1.1 kg/m2, 95% CI (0.5-1.8)), and WC (b = 3.6 cm, 95% CI (1.8-5.3)). A dose–response relationship between ACE accumulation and both BMI and WC was also found to be significant. Furthermore, accumulation of 4 or more ACEs was significantly associated with clinical obesity (95th percentile), after controlling for the aforementioned covariates.
Conclusions
In a community sample of grade six to eight children, accumulation of 4 or more ACEs significantly increased BMI, WC and resting HR. Therefore, risk factors related to reported associations between ACEs and cardiovascular outcomes among adults are identifiable in childhood suggesting earlier interventions to reduce CVD risk are required.
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology, and Child Health
Reference39 articles.
1. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS: Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med. 1998, 14 (4): 245-258. 10.1016/S0749-3797(98)00017-8.
2. Danese A, Moffitt TE, Harrington H, Milne BJ, Polanczyk G, Pariante CM, Poulton R, Caspi A: Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation and clustering risk factors. Arch Pediatr Adolesc Med. 2009, 163 (12): 1135-1143.
3. Dong M, Giles WH, Felitti VJ, Dube SR, Williams JE, Chapman DP, Anda RF: Insights into causal pathways for ischemic heart disease: adverse childhood experiences. Circulation. 2004, 110 (13): 1761-1766. 10.1161/01.CIR.0000143074.54995.7F.
4. Goodwin RD, Stein MB: Association between childhood trauma and physical disorders among adults in the United States. Psychol Med. 2004, 34 (3): 509-520. 10.1017/S003329170300134X.
5. Stein DJ, Scott K, Haro Abad JM, Aguilar-Gaxiola S, Alonso J, Angermeyer M, Demytteneare K, de Girolamo G, Iwata N, Posada-Villa J, Kovess V, Lara C, Ormel J, Kessler RC, Von Korff M: Early childhood adversity and later hypertension: data from the world mental health survey. Ann Clin Psychiatry. 2010, 22 (1): 19-28.