What’s New in Psychology?

How Childhood Abuse Affects your Heart

Jim Windell

           Cardiovascular disease, which includes heart disease and stroke, is more common among older people. However, the risks often begin much earlier in life.

           But, how much earlier?

           Some research in the past has found that physical and psychological abuse and other adverse experiences in childhood increase the risk of developing obesity, Type 2 diabetes, high blood pressure and high cholesterol. Having these conditions tends to increase the risk for cardiovascular diseases. This was detailed in the 2018 “American Heart Association Scientific Statement: Childhood and Adolescent Adversity and Cardiometabolic Outcomes.”

           Conversely, previous research has found, healthy childhood experiences – nurturing, loving relationships in a well-managed household, including having family members who are involved and engaged in the child’s life – may increase the likelihood of heart-healthy behaviors that may decrease the cardiovascular disease risks.

           A new study, recently published in the Journal of the American Heart Association, explored whether nurturing relationships and well-managed households might offset the likelihood of higher cardiovascular risk factors.

           This study was a retrospective analysis of data collected in the Coronary Artery Risk Development in Young Adults (CARDIA) study in 2015-2016. Researchers examined information from the CARDIA study, an ongoing, long-term study among 5,115 Black and white adults enrolled from 1985-1986 to 2015-2016. Study enrollment occurred in four U.S. cities: Birmingham, Alabama; Chicago; Minneapolis; and Oakland, California. More than half of the study participants were women, and nearly half were Black adults. At the start of the study, participants were 25 years old, on average. All participants received initial clinical examinations and eight additional examinations every few years to assess cardiovascular risks over 30 years.

           At ages 33 to 45, participants completed a survey of questions to assess areas of their family life during childhood. For this analysis, three areas were examined:

• Abuse: how often a parent or adult in their home pushed, grabbed, shoved or hit them so hard that they were injured; and how often a parent or adult in their home swore at them, insulted them or made them feel threatened.
• Nurturing: how often a parent or adult made them feel loved, supported or cared for; and how often a parent or adult in the family expressed gestures of warmth and affection.
• Household organization: did they feel the household was well-managed, and did their family know where they were and what they were doing most of the time. (No definitions or criteria were provided for the term “well-managed;” study participants were instructed to determine if the term described their childhood family experience.)

           This study found that risk factors for heart disease and stroke were higher among adults who said they experienced childhood abuse. However, those who described their family life as well-managed and had family members involved in their lives during childhood were less likely to have increased cardiovascular risk factors as adults.

           The study’s lead author, Liliana Aguayo, Ph.D., M.P.H., a social epidemiologist and research assistant professor at Emory University’s Rollins School of Public Health in Atlanta, and her colleagues found that, more specifically, the risk of high cholesterol was 26% higher among white women and 35% higher among white men who reported low levels of abuse in childhood, compared to same sex and race adults who reported no abuse in childhood. In addition, the risk of Type 2 diabetes was 81% higher among white men who reported occasional/frequent abuse during childhood, compared to adults who reported no abuse in childhood. And it was also revealed that Black men and white women who said they experienced abuse and grew up in a dysfunctional household were more than 3.5 times as likely to develop high cholesterol as those who reported no abuse during childhood. In contrast, among people who reported growing up in a well-managed household, the risk of high cholesterol decreased by more than 34%. Finally, an unexpected finding in the research was that the risk for cardiovascular disease risk factors was not higher among Black women who reported experiencing abuse in childhood.

           According to Dr. Aguayo, “Our findings demonstrate how the negative and positive experiences we have in childhood can have long-term cardiovascular consequences in adulthood and define key heart disease risk disparities by race and sex.”

           She went on to say that “Further research is needed to better understand the potential mechanisms linking childhood abuse and family environment to higher heart disease risk factors, as well as the impact of structural racism and social determinants of health, which likely influenced the differences we found by race and sex.”

           Dr. Aguayo concluded by noting that the information from this research is critical to strengthening cardiovascular disease prevention interventions and policies – particularly those that focus on people who experienced abuse or other trauma during childhood.

           To read the original article, find it with this reference:

Liliana Aguayo, Diana A. Chirinos, Nia Heard‐Garris, Mandy Wong, Matthew M. Davis, Sharon Stein Merkin, Teresa Seeman, Kiarri N. Kershaw. (2022). Association of Exposure to Abuse, Nurture, and Household Organization in Childhood With 4 Cardiovascular Disease Risks Factors Among Participants in the CARDIA Study. Journal of the American Heart Association; DOI: 10.1161/JAHA.121.023244